Evaluation and Management of Pediatric Stones

The frequency of kidney stones has increased in recent years in children and adolescents. The greatest incidence rise is seen in teenage girls and childhood stones are now more common in females than in males. Calcium-based stones are most common while infection-related stones account for less than 5% in recent studies. All children with kidney stones should undergo a thorough urinary metabolic risk factor evaluation as hypercalciuria, hyperoxaluria, hypocitraturia, hyperuricosuria, extremes of urinary pH, and low fluid intake are seen in up to 95% of first-time pediatric stone formers. A number of effective preventive therapeutic strategies, including dietary modifications and pharmacotherapy, can be implemented in an effort to reduce the risk of stone recurrence. To optimize outcomes, pediatric stone formers should preferably be followed in stone prevention clinics by a medical team with special interest in childhood kidney stone disease.