Why more children get kidney stones – a disease of “white middle-aged men”

More children across America get kidney stonesExperts say the condition is currently incorrectly associated with “white, middle-aged men.”

Stones are pebble-like masses of minerals and salts that form inside the kidneys. They are usually smaller than a peppercorn or just a little larger. Color may change. Stones can cause sharp pain in the back, side, lower abdomen, or groin, but small stones may cause no symptoms. When treated by a medical professional, it rarely causes permanent damage, but Increases risk of developing chronic kidney disease.

And although they are very common, Incidents are on the rise overallAccording to National Institute of Diabetes and Digestive and Kidney Diseases. The institute notes that in addition to people with a family history of developing stones, men are also more likely to develop the condition.

One of them was Alina Fee, a 4-year-old girl from New Jersey who didn't have any pain or typical signs of stones. Doctors didn't know how long they had been there, and she was scheduled to undergo minimally invasive surgery to destroy three large stones, Children's Hospital of Philadelphia said in a 2016 statement.

About half of childhood kidney stones recur within five years, but Alina has recovered and is back to her Saturday dance class.

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“On Friday nights, she tells me she can't wait to be a pink ballerina the next day,” says her father, Rob Fee. I told the hospital.

Kidney stones should occur, but It is not considered a disease that mainly affects “white middle-aged men” Dr. Gregory Tashian, a pediatric urologist at Children's Hospital of Philadelphia, said it's over. independent person Thursday email. Tashian treatment costs.

“My clinical work focuses exclusively on children and adolescents with early-onset nephrolithiasis. When I was a resident from 2005 to 2011, stones were rare in children. Now, treating children with stones is almost all of my work,” he wrote.

Kidney stones affect 11 percent of the U.S. population, Tashian said. Numerous studies have documented that children are at increased risk over time. Tashian's March 2016 study found that American Society of Nephrology Clinical Journal, He found that the average annual incidence increased from 1997 to 2012, with the greatest increase among 15- to 19-year-olds. In 2012, the research results were published in the journal. Urology Journal The incidence was found to increase by 4% annually over 25 years. previous paper pediatric journal There was also a “significant increase” in children suffering from kidney stones between 1996 and 2007.

Almost a year ago, Dr. Kate Craft, a pediatric urologist at University of Michigan Health CS Mott Children's Hospital, also reported seeing an increase.

“There is increasing by 10% every year In the last 10 years or so. “It certainly shows an epidemiological increase,” she said.

The fastest growing population is among adolescents; especially adolescent girlssaid Tashian. He noted that further research is needed to understand the causes of the increased prevalence and to assist in the clinical management of children with kidney stones. Treatment for children is almost the same as for adults.: Medication to prevent the stone from recurring and a procedure to blow the stone into small pieces.

But while this upward trend has been documented, Dr. David Sass, a pediatric nephrologist at the Mayo Clinic who worked with Tashian, said: independent person It's “kind of under the radar.”

“We don't know exactly why,” Sass said of the increase in adolescent girls.

“For adolescent females to have a different slope than adolescent males, to me there are only two possibilities. One is that there is something related to hormones that increase during puberty in females. The idea is that it increases the risk of stones, but it hasn't been determined yet. Alternatively, there may be something different about the diet of adolescent women compared to adolescent men. “Hmm,” he says.

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Kidney stones are Caused by high levels of minerals, calcium, and oxalatesphosphorus in urine. These minerals are normally found in urine and do not cause problems at low levels. However, dehydration and diet can cause buildup. Some people develop stones because of their family's genetic history, and rising temperatures may also play a role. Children are prone to dehydration.

Dr. Sass noted that while he believes the hormone hypothesis is likely not the cause of the increase in cases in adolescent girls, it is in fact more likely to be the cause. Puberty occurs earlier over time. He believes that adolescent girls may be consuming more of the foods associated with kidney stone formation.

“We know that we have significantly increased access to foods that are high in sodium, and I think that's the number one culprit,” Sass said, adding that research has shown that Americans are more likely than ever to He also pointed out that it has been shown that people are consuming a lot of salt. Sodium, like phosphorus, is used as a preservative in processed foods. Unlike sodium, phosphorus does not need to be listed on food labels.

For everyone who forms stones, too much salt is a factor, as is not drinking enough water, Sass explained.

“Many children don't drink enough water or don't want to drink water, but water is best. If you keep your urine diluted, the minerals will be better diluted and precipitated out of your urine. “They are less likely to develop kidney stones,” says Dr. John Wiener, a pediatric urologist at Duke University. Health, I said.

Calcium, the most abundant mineral in the body, may also play an important role. The body requires calcium to build and maintain strong bones and perform many important functions.

Dr. David Goldfarb, a nephrologist at New York University Langone who specializes in the evaluation, management and prevention of kidney stones, points out that people are eating less dairy, which means less calcium intake. I did.

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“And more calcium is associated with less kidney stones, so that's probably part of it,” he said.

Goldfarb says there are reasons to think so. High temperature is a factorhe said. independent person He said they have new data showing that kidney stones are more common in hotter parts of California. Still, he said, it cannot be argued that it is a major factor or part of the risk.

So is the answer to reducing the incidence of kidney stones, pediatric or otherwise, as simple as it seems?

“In much the same way that these measures help prevent obesity, prevent heart disease and high blood pressure, they also help prevent kidney stones,” Professor Wiener said.

Mitigating measures may “seem obvious,” Goldfarb asked. “But how do we get people to drink more?” He noted that children may have better access to toilets than adults.

It might all come down to what's for dinner.

“If I could change anything with the snap of my fingers, it would be to get people to eat freshly prepared food,” Sass said.