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The newspaper of The Johns Hopkins University January 8, 2007 | Vol. 36 No. 16
Kidney Stones Occurring More Often in Children

By Katerina Pesheva
Johns Hopkins Medicine

Kidney stones in children — considered all but a medical aberration until recently — are now becoming a fairly common condition. It's a growing and disturbing trend that has pediatricians at the Johns Hopkins Children's Center, and around the country, sounding the alarm.

While doctors have yet to quantify the precise increase and tease out the factors behind it — better detection devices probably play some role — pediatricians agree that the main culprits are probably too much salt and too little drinking water in children's diets.

"More and more children with kidney stones are coming to us," said kidney specialist Alicia Neu, co-director of the kidney stone clinic at the Children's Center. "While this is somewhat unexpected, it is not totally surprising given that so many other conditions are on the rise in children due to poor diet, such as high blood pressure, type 2 diabetes and obesity, to name a few."

Kidney stones are rarely a serious condition but can be extremely painful and can cause urinary tract infections.

Limiting salt in the diet and drinking plenty of water are the best ways to prevent the most common types of kidney stones or slow their growth. Here are several simple tips to keep in mind:

Doctors recommend consuming no more than 2.4 grams of sodium a day, or 6 grams (1 teaspoon) of table salt a day.

Stay away from salty snacks, such as chips and pretzels.

Be aware that processed foods, including smoked and cured meats, sodas and canned products have the highest sodium content.

Look for "no salt added" or "low sodium" labels when buying food.

Rinse canned foods under water to remove some of the sodium.

Tea, coffee, dark chocolate, spinach, nuts and wheat bran can increase the risk of certain types of kidney stones.

A child needs to drink 64 ounces of water a day.

Sugar-laden juices and sodas don't count as proper hydration.

Urologist Yegappan Lakshmanan, co-director of the Children's Center's pediatric stone clinic, said, "Clearly, when it comes to water consumption, what is needed is a cultural change, and schools have to play a role in making bottled water available and limiting soft drinks, as well as allowing children to visit the restroom as needed."

A good way to tell if a child is drinking enough water is his or her urge to urinate every three hours; if a child urinates less frequently, it might be a sign of dehydration, Lakshmanan said.

Signs and symptoms of kidney stones include intense pain in the lower back and/or sides; frequent and painful urination; blood in the urine and/or cloudy urine; and urinary tract infections, secondary to kidney stones, accompanied by fever.


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