Suggest Treatment For Kidney Stone In Children

Posted on Fri, 16 Oct 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Fri, 16 Oct 2015 Answered on

Tue, 10 Nov 2015 Last reviewed on

Question : My 7 month old son has developed a 3mm calculus in the lower pole of left kidney. What is this? kidney stone? Will it pass and nothing needs to be done. On side note he does have upj. He is so young and I'm concerned.

Answered by Dr. Rakesh Madhyastha (14 hours later)

Brief Answer:
Needs evaluation

Detailed Answer:
Hello

Thanks for the query

It looks like your son is having a kidney stone. No intervention is required at the moment if there is no hydronephrosis. However stones are not common in such young children and requires evaluation.
I recommend you to meet a nephrologist and get the following initial tests done
1. Serum calcium 2. Serum phosphorus 3. Vit D 4. Alkaline phosphatase 5. Serum creatinine and 6. Electrolytes to rule out any metabolic disease

For now make sure he is well hydrated, if you have started feeding him then make sure to add fruits and vegetables into the diet. Avoid giving chocolates

Do not ignore this matter, he requires evaluation at the earliest

I hope I was of help, if you have any further queries please get back to me
Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rakesh Madhyastha (26 minutes later)

He actually does have hydronephrosis in the left kidney. Considered a Level 3 on 0-4 scale which is pretty high. Also UPJ. What are your thoughts now on what needs to be done since you said no intervention was needed unless he has hydronephrosis and he does have it at a level III.

Answered by Dr. Rakesh Madhyastha (23 hours later)

Brief Answer:
stenting

Detailed Answer:
Hello

Thanks for getting back. I am sorry for the short delay in my reply, I was on call at my hospital.
Hydronephrosis requires DJ stenting, which means that a small tube will be placed in the ureter and it will relieve that obstruction to the kidney. It is done by pediatric surgeons and urologists. Mild PUJ will get corrected once the child grows, most of my patients have recovered from PUJ by the age of 2 -3 years, a close follow up is required for it.
At this point it is most important to undergo metabolic work up for stone disease, please get the tests I have jotted down earlier

Regards

Above answer was peer-reviewed by : Dr. Raju A.T

Follow up: Dr. Rakesh Madhyastha (3 days later)

The urologist at this point wants to do another ultrasound in 3 months and not do anything until then. He still believes we will be heading toward pyloplasty at some point but the bigger my baby gets, the easier it will be to get the kidney stone out and fix the UPJ at the same time. I asked him about the tests you suggested and he thinks we are jumping the gun and there is no need right now until what we see what happens at next ultrasound. Do you agree? What are your thoughts? Also he still isn't completely ruling out UVJ either.

Answered by Dr. Rakesh Madhyastha (15 hours later)

Brief Answer:
Disagree with the urologist

Detailed Answer:
Hello

Thanks for getting back

I disagree with the urologist. Any child in this age group with stone should undergo metabolic work up. I recommend that you seek second opinion from a pediatric nephrologist if possible.
I agree to the idea of waiting for 3 months to undergo pyeloplasty later on but the child should be on regular follow up and one should watch out for urinary tract infections .

Regards

Above answer was peer-reviewed by : Dr. Vinay Bhardwaj