Dr. Chan discusses risk factors for kidney stones in children

In this video, Katherine Chan, MD, MPH, discusses risk factors for kidney stones in children. Chan is vice chair for research, director of the Pediatric Kidney Stone Clinic, director of Pediatric Urology Research, and an associate professor of urology at the University of North Carolina, Chapel Hill.

Transcription:

What are the biggest risk factors for kidney stones developing in children, and are there any specific dietary or lifestyle changes you recommend for prevention?

Kidney stones in children are quite a bit different than in adults. In adults, we think of dietary factors being really important. And interestingly, stones are more common in adults than in children. In children, we’re more concerned about metabolic or genetic abnormalities, meaning things that they inherited from their parents. And to that end, children also have a much higher risk of recurrent stone disease. Stones that recur in children happens about 40% to 50% of the time. That’s why the American Urological Association guidelines recommend doing a complete metabolic evaluation in all children. But as far as the biggest risk factors in children, the most common cause overall is metabolic. Of those metabolic causes, hypercalciuria, or high calcium levels in the urine, is overall the most common metabolic abnormality in children with kidney stones. And that is found in about 50% to 97% of children with identifiable metabolic disease. This can be caused by a variety of different things such as disturbances in the kidney, the intestinal tract, and the bone. So it really is quite heterogeneous and really, the underlying etiology, and again, the prevalence and the incidence and all these risk factors really vary a lot in terms of gender, age, race, dietary habits, and even some socioeconomic factors. Interestingly, boys are more affected in the first decade of life, and their main risk factor tends to be obstructive processes in the urinary tract. Girls are more affected in the second decade of life, and their main risk factor is UTIs, particularly in post pubertal and sexually active girls. There are some racial differences too. Stones are more common in non Hispanic White children compared to Hispanic children, and they’re least common in African American children. Interestingly, there’s a higher incidence reported in children who live in Western countries and rural communities and also hot and dry climates such as North Carolina.

This transcription was edited for clarity.