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Thirty years ago, kidney stones were considered a disease of the middle-aged white man. Now, doctors are increasingly seeing a different type of patient suffering from this extremely painful condition, especially during the summer.
Kidney stones, hard deposits of minerals and salts that can get trapped in the urinary tract, are now occurring in younger people, particularly teenage girls, emerging data shows.
Experts aren’t sure why more children and teens are developing the condition, but they speculate a combination of factors is to blame, including diets rich in ultra-processed foods, increased use of antibiotics at a young age and climate change that causes more cases of dehydration.
Doctors who spoke to NBC News said they see more children with kidney stones in the summer than in any other season.
kidney stones Nephrolithiasis is a metabolic disorder, also known as nephrolithiasis, that occurs when minerals such as calcium, oxalate, and phosphorus accumulate in the urine and form hard, yellowish crystals the size of a grain of sand or the size of a golf ball in the urine. severe cases. Some stones pass out of the urinary tract without a problem, but others can get stuck, blocking the flow of urine and causing severe pain and bleeding.
In recent years, hospitals across the country have opened pediatric “stone clinics” to meet the demand, where children can meet with urologists, nephrologists and nutritionists to receive the care they need to treat and prevent future kidney stones.
Kidney stones in adults are linked to conditions such as metabolic syndromeobesity, hypertension and diabetes.
“In children, we’re not seeing that,” said Dr. Gregory Tasian, a pediatric urologist at Children’s Hospital of Philadelphia. “They are otherwise healthy and just have their first kidney stone for unclear reasons.”
Much of the research on nephrolithiasis in children in the US has been led by Tasian and colleagues and is focused on finding the cause. “Clearly something has changed in our environment that is causing this rapid change,” she said.
About 10% of people in the US will have a kidney stone at some point in their lives, according to the National Kidney Foundation. Stones can be found in children. as young as 5 years.
Chloe Carroll, now 14, was just 8 years old when she found blood in her urine during a dance recital. Doctors diagnosed her first kidney stone, a surprise for a young athlete with no underlying medical conditions.
Less than a year later, she was hit with a second rock. At age 11, she developed another: all three of her stones required surgical removal.
“It’s still nerve-wracking to have to go through that over and over again,” Carroll, now 14, said through tears as she recalled the fear of having surgery. “But I know it’s a part of life and I have to move on.”
How many children develop kidney stones?
Kidney stones are not common in children, although the rate is unclear because most research has focused on adults.
One estimate comes from a 2016 study led by Tasian that included nearly 153,000 adults and children in South Carolina who received emergency, hospital, or surgical care for nephrolithiasis.
The research, published in the Clinical Journal of the American Society of Nephrology, found that the annual incidence of kidney stone disease increased 16% from 1997 to 2012, with youth ages 15 to 19 experiencing the largest increase. Within this age group, the incidence of kidney stones was 52% higher among girls and women. The disease became more common in men after the age of 25.
Overall, the risk of kidney stone disease doubled during childhood for boys and girls, while women experienced a 45% increased lifetime risk over the 16-year study period. Black adults and children in the study also developed kidney stones at a higher rate than whites.
Similar trends have been reported in other studies, including one conducted in Olmsted County, Minnesotawhich found that the incidence rate of kidney stones among children aged 12 to 17 increased by 6% per year between 1984 and 2008.
Is diet related to kidney stones?
Experts believe that worsening children’s diets may play a role.
The high amounts of sodium in French fries, sandwiches, sports drinks, and packaged meals can force extra minerals into the urine that can accumulate in kidney stones. It is especially likely if a child does not drink enough water or drinks too many sweetened beverages high in fructose corn syrup.
It’s like trying to dissolve sugar in an almost empty coffee cup, he said. Dr David Chupediatric urologist Ann & Robert H. Lurie Children’s Hospital of Chicago who conducts research with Tasian.
Hotter summers cause more kidney stones
The hotter and more humid it is, the more you sweat and the less you urinate, which allows minerals to bind in your kidneys and urinary tract. Children are especially vulnerable to heat.
Dr. Christina Carpenter, acting chief of pediatric urology at New York-Presbyterian Morgan Stanley Children’s Hospital, said she has already treated more children with kidney stones over the summer.
Studies have found that the number of people who seek medical attention for kidney stones increases as mean daily temperatures rise. Other research shows that the Southeastern US, known as the “kidney stone belt,” has up to 50% higher prevalence of kidney stone disease than the Northwest.
A 2008 study predicted the the “belt” will inevitably expand upwardswith the fraction of the US population living in “high-risk areas” growing from 40% in 2000 to 70% in 2095.
An antibiotic link to kidney stones
Antibiotics can alter the gut microbiome in a way that favors the development of kidney stones, Tasian said.
In 2018, Tasian’s team found that people taking any of the five commonly prescribed oral antibiotics were associated with a 1.3 to 2.3 times increased odds of develop kidney stones. The risk decreased over time, but remained high for up to five years after taking the drug, and was higher when it was given at younger ages.
because many antibiotics are prescribed unnecessarily in the US.Tasian called it a “leading theory” for the rise in children developing kidney stones.
The earlier a person develops kidney stones, the more time they have to develop a more serious form of the disease and long-term health problems associated with that, Tasian said. Some of the consequences include loss of kidney function, decreased bone mineral density that could lead to fractures, and an increased risk of heart disease in adulthood
Children who develop a stone are about a 50% chance to develop another within five to seven years, according to the National Kidney Foundation.
Each stone that passes through the urinary tract increases the risk of developing ureteral stricture, which is a narrowing of the tube that drains urine from the kidneys to the bladder, Carpenter said.
When this happens, children may need to have invasive surgery to fix it.
The trend is also concerning because there is limited evidence on how best to treat children with kidney stone disease, experts say.
Symptoms of kidney stones
According to the National Institute of Diabetes and Digestive and Kidney Diseases symptoms include:
- Sharp pains around the back, lower abdomen and groin.
- Pink, brown, or red blood in the urine.
- Constant need to urinate.
- Cloudy or foul-smelling urine.
- Irritability, especially in young children.
Some children may not experience any symptoms. However, symptoms can sometimes be “more non-specific” in children, particularly younger ones, Carpenter said, so they might complain of stomach aches, rather than back pain or nausea, for example.
To avoid kidney stones
Drink plenty of water, especially during the warmer months, experts say.
Not sure if you’re drinking enough? Make sure her urine resembles a light lemonade color, Carpenter said. If it’s darker, hydrate more.
