Thousands of children hit by agonizing ailment usually suffered by the elderly… and the sinister reasons why
Kidney stones have long been considered an ailment of the elderly, but doctors warn that is rapidly changing.
They warn thousands of children are being struck down by the agonizing condition that leaves them in excruciating pain for a few days to a few weeks.
In the past five years nationally, the rate of kidney stones rose 28 percent for girls and 23 percent for boys aged 15-19.
But some hospitals, like the one at the University of Michigan, have seen yearly rises of 10 percent over the past decade, which they argue represents ‘an epidemiologic rise.’
A confluence of troubling factors is to blame. Doctors say food companies are putting more salt in their recipes, which forces the kidneys to work harder, leading to increased calcium in the urine that crystallizes into hard stones. A rise in generally unhealthy diets is also thought to be a factor.
Meanwhile, some doctors have linked rising temperatures from climate change, which they say contributes to dehydration. When the body lacks adequate fluids, it passes less urine, which makes it harder for the kidneys to flush out toxins like calcium.
Kidney stones are calcium mineral deposits that accumulate in the urinary tract and migrate to the bladder to be urinated out, causing sharp pain in the abdomen, nausea, vomiting, pinching or stinging when urinating, and potentially blood in the urine.
Dr Kate Kraft, a pediatric urologist at the University of Michigan’s CS Mott Children’s Hospital, said: ‘Some people say that passing a kidney stone is the worst pain that they have ever had.’
A 9-year-old has an ultrasound at Children’s Hospital of Philadelphia to screen for kidney stones. He and his twin brother are being observed due to their mother’s history of kidney stones when she was young
Kidney stones are more common among people in their 40s to 60s.
There are no reliable figures for kidney stone prevalence in the US because reporting methods vary, data isn’t always collected consistently, and people may be diagnosed or treated differently.
Also, some people don’t go to the doctor for small stones or may pass them on their own, making it even harder to track.
But doctors have consistently reported seeing a higher share of young patients since at least 1997.
Dr Zachary V. Zuniga, a pediatric urologist at Texas Children’s Hospital, told the Washington Post: ‘We see, every day, children presenting with kidney stones.
‘The thought is that kids don’t get stones. That’s like, the last thing you may think about when a child has pain somewhere as a symptom.’
Children have historically been at such low risk of kidney stones that many doctors miss the signs, leaving children to suffer.
Many of the children presenting to the emergency department in severe pain and blood in their urine are also otherwise healthy, a significant difference from the older adults who generally get kidney stones.
Dr Gregory Tasian, a pediatric urologist at the Children’s Hospital of Pennsylvania, is shown checking for kidney stones in a nine-year-old patient
Older adults are typically more prone to kidney stones for a variety of reasons.
They are more likely to be overweight and obese, a top risk factor, are more likely to be diabetic, have high blood pressure, heart problems, and high cholesterol.
People generally pass the stones when they urinate, though doctors sometimes have to surgically intervene, using shock waves to break up the calcium deposits, using a thin tube inserted through the urethra to remove the stone, or making a small incision in the back to remove or break up even larger stones.
Doctors believe a leading culprit is a poor diet full of processed and high-sodium foods, which can cause calcium in urine to crystalize and accumulate, forming small hard rocks.
The average amount of sodium the average American consumes everyday has remained relatively stable, at around 3,700 milligrams per day, since the 1970s.
Over three-quarters of the salt people consumes comes from ultra-processed foods, a growing presence in millions of Americans’ diets. Salt-laden UPFs make up nearly 70 percent of the calories that children and teenagers consume everyday.
And more than 90 percent of children take in more an a thousand excess milligrams of sodium per day comapred to the recommended 2,300 milligrams per day or about one teaspoon.
When the body takes in too much sodium, the kidneys must work harder to eliminate it by increasing calcium leakage into the urine to maintain balance.
Experts believe that high-sodium diets are increasing the number of kidney stone cases presenting at the hospital
Extra calcium in the urine can combine with other substances like oxalate or phosphate to form stones ranging in size from a grain of rice as large as a grape.
Sky-high sodium intake has coincided with an increased number of reported kidney stones, from 3.8 percent in the late 1970s to 8.8 percent in the late 2000s.
Annabelle Pleskoff, 25, began experiencing kidney stones a decade ago. She woke up for school one morning with severe pain in her abdomen, which doctors first believed was appendicitis.
They later learned the Seattle native had kidney stones for the first of what ended up being 30 times.
Growing up, her condition rendered her unable to participate in activities she loved, including the swim team.
Having learned about the ties between sodium and kidney stones, she adhered to a highly restrictive diet that plunged her into the depths of anorexia.
She said: ‘Just the idea that if I restricted my diet, I wouldn’t be in as much pain, and then I ended up restricting a little too much and not eating enough to keep my body healthy.’
Ms Pleskoff was otherwise healthy when she experienced her first bout of painful kidney stones, with no known genetic predisposition, which doctors increasingly believe plays a role as well.
At 25, Annabelle Pleskoff recalls her first kidney stone episode at age 15. What doctors initially thought was appendicitis turned out to be kidney stones, marking the start of 30 such occurrences over the years
An estimated 40 percent of kidney stones are caused by inherited genetic traits.
Some of the genetic conditions known to cause kidney stones include cystinuria, which causes excess cystine (an amino acid) to be excreted in the urine, leading to the formation of stones, and hypocitraturia, which results in lower levels of citrate in the urine and reduces the natural ability to prevent stone formation.
Other genetic conditions include hypercalciuria, which causes elevated calcium levels in the urine and promotes the development of calcium oxalate stones, and enteric hyperoxaluria, which occurs when intestinal diseases cause excess oxalate to be excreted in the urine, combining with calcium to form calcium oxalate stones.
Four-year-old Alex Zellers of Los Angeles was born with cystinuria. The condition led to frequent kidney stones, some growing as big as a lacross ball. They were so large they had to be surgically removed.
His mother Kate said: ‘It’s just like a giant dense egg. It’s just a big mass.’
Researchers also hypothesize that the ravages of climate change have contributed to the rise in children plagued with this condition.
Kidney stones are more common in hotter, humid climates, where people are more likely to sweat and become dehydrated.
Alex (pictured) has been dealing with painful kidney stones nearly his entire life as a result of a genetic disease called cystinuria, which means his body does not absorb certain amino acids
One stone in Alex’s kidney was as big as a golf ball, while another in his bladder was the size of a lacrosse ball
In 2008, researchers in Texas postulated that a rise in global temperatures has led to the formation of a ‘kidney stone belt’ across the southeastern US, where they are more common. And as temperatures continue to rise, the number of people impacted will explode.
They estimated that by 2050, the percentage of the population living in high-risk areas for kidney stones will grow from 40 percent in 2000 to 70 percent by 2095.
They also predict an additional 1.6 to 2.2 million lifetime cases of kidney stones by 2050, with some regions seeing increases of up to 30 percent.
Dr Gregory Tasian, a pediatric urologist at the Children’s Hospital of Pennsylvania, said: ‘With climate change, we don’t often talk about the impact on human health, particularly when it comes to children, but a warming planet will have significant effects on human health.’
Doctors also argue that schools are doing too little to encourage healthy habits that can prevent kidney stones, including allowing students to carry water bottles with them to stay hydrated during the day.
Dr David Sas, a pediatric urologist at the Mayo Clinic, said: ‘Temperature, humidity plus diet equals stones.
‘I write a lot of letters saying that so-and-so must have free access to water and the restroom due to a risk of kidney stones.’
There has also been some compelling evidence pointing to a rise in the use of medically unnecessary antibiotics, which, Dr Kraft said, ‘may actually affect how the gut absorbs the minerals that are in kidney stones and the amount of those minerals in the urine.’
Five types of oral antibiotics – sulfa drugs, cephalosporins, fluoroquinolones, nitrofurantoin, and broad-spectrum penicillins – have been linked to a higher risk of kidney stones.
Dr Tasian and other researchers analyzed health records of 13 million people in the UK from 1994 to 2015. They compared roughly 26,000 patients with kidney stones to about 260,000 people without them.
Sulfa drugs more than doubled the risk, while broad-spectrum penicillins increased the risk by 27 percent, even after accounting for factors like age, sex, urinary tract infections, and other medications.
Children and teens had the highest risk, and although the risk decreased over time after taking antibiotics, it remained elevated for several years.
Dr Tasian said that when a common and rising condition is linked to excessive antibiotic use, ‘it just adds additional weight to the importance of judicious and appropriate use of antibiotics.’
