Kidney stones in children (bacchon me pathri)
Kidney stones are less common in children than in adults, but they are seen regularly, especially in hot regions such as Rajasthan where children lose a lot of fluid in summer. In some parts of India, bladder stones are also still seen in young children, linked to diet and dehydration.
Children often cannot describe stone pain the way adults do. Signs to watch for include:
- tummy pain or side pain, sometimes coming in waves
- blood in the urine, or pink or cola-coloured urine
- urine infections with fever, especially repeated ones
- vomiting, irritability, or crying while passing urine in babies and toddlers
- passing grit or small stones in the urine
Some stones cause no symptoms and are found on an ultrasound done for another reason. Read about when a child with a stone should see a urologist, and about kidney stones in general.
Why children get kidney stones
A stone in a child is a sign that something is encouraging stone formation. Finding that cause is the most important step in preventing more stones.
| Cause | Examples |
|---|---|
| Metabolic | Too much calcium in the urine (hypercalciuria), too little citrate, high oxalate or uric acid, and inherited conditions such as cystinuria |
| Infection | Repeated urine infections, especially with bacteria that make the urine alkaline and form infection (struvite) stones |
| Anatomy | A narrowing at the kidney outlet (PUJ obstruction), urine flowing back from bladder to kidney (vesicoureteral reflux), a widened ureter (megaureter), or a bladder that does not empty well |
| Other | Low fluid intake, salty packaged food, premature birth and some medicines, long periods of bed rest, bowel disease and a family history of stones |
Anatomical causes often need their own treatment, such as pyeloplasty for PUJ obstruction or treatment for reflux, sometimes in the same operation as stone removal.
Tests and metabolic evaluation for a child with stones
- Ultrasound first: it shows most kidney stones and any swelling of the kidney, without radiation.
- Low-dose CT: used when ultrasound is unclear or before surgery, with the dose kept as low as possible.
- Urine routine and culture: to look for infection.
- Blood tests: kidney function, calcium, phosphate, uric acid and other salts, and sometimes parathyroid hormone.
- Stone analysis: any stone passed or removed is sent to the laboratory to find its type.
- Urine collection: a 24-hour collection in older children, or spot urine samples in younger ones, to measure calcium, oxalate, citrate, uric acid and cystine.
Guidelines recommend this metabolic evaluation for every child with a stone, because an underlying cause is found in many of them. A paediatrician or paediatric nephrologist (children's kidney doctor) may share the care for some metabolic conditions.
Which kidney stone treatment is suitable for your child
The options are the same as the kidney stone treatment used in adults, adapted to a child's smaller size. Children often pass fragments more easily than adults, which helps.
| Situation | Usual options |
|---|---|
| Small stone, no blockage or infection | Watching with ultrasound, fluids and treating the cause |
| Kidney stone under about 1.5-2 cm | ESWL or RIRS |
| Ureter stone that will not pass | URS with a small-calibre ureteroscope |
| Larger or harder kidney stone | Mini-PCNL or Micro-PERC |
| Stone with PUJ obstruction or other anatomy needing repair | Laparoscopic or open surgery with repair |
| Bladder stone | Removal through the urine passage or, for a large stone, through a small cut above the pubic bone |
A small stone that is not growing and causes no symptoms usually does not need a procedure, but it is still watched and its cause investigated. A blocked kidney with fever is an emergency in children as in adults, and the kidney is drained first. Other children's urinary problems are covered on the pediatric urology page.
How stone procedures are done in children
- General anaesthesia: all telescope procedures, and ESWL in most young children, are done under general anaesthesia so that the child stays still and feels nothing. Fasting times are set by the anaesthetist for the child's age, and a parent can usually stay until the child is asleep.
- Child-sized instruments: small-calibre cystoscopes and ureteroscopes, thinner sheaths and fine laser fibres suited to a child's narrow urethra and ureter.
- Pre-stenting: because a child's ureter is narrow, a DJ stent is placed first more often, with the main procedure 1-2 weeks later.
- Lower radiation: ultrasound is used where possible, and X-ray time is kept short.
- Laser: the 150W Holmium laser available at ManglamPlus Medicity is used through these fine instruments, with settings adjusted for the stone.
Procedures usually take 30-90 minutes and are done in the operation theatre at ManglamPlus Medicity, Mansarovar.
Hospital stay and recovery for children
| When | What to expect | What to do |
|---|---|---|
| Day of procedure | Sleepy after anaesthesia; burning while passing urine | Feeds or fluids as soon as allowed; a parent stays with the child |
| Days 1-2 | Most children go home (after ESWL, the same day) | Plenty of fluids; prescribed syrups or tablets |
| Week 1 | Back to play; school after a few days for most | Avoid rough play while a stent is in |
| Weeks 1-4 | Stent removed, usually under a short anaesthetic | Ultrasound check; stone analysis reviewed |
Unless the stent was left with a thread, children usually need a brief general anaesthetic to have it removed. Call the clinic if your child has fever, refuses to drink, vomits repeatedly, passes very little urine, or seems in more pain than expected.
Risks of stone treatment in children
The risks are similar to those in adults: urine infection and fever, blood in the urine, stent discomfort, leftover fragments needing a second procedure and, rarely, injury to the ureter. Serious problems from anaesthesia are rare in healthy children, and the anaesthetist explains the specific risks for your child before the procedure.
Repeated X-ray exposure is a particular concern in children, which is why ultrasound is used for most follow-up. Studies have not shown ESWL harming the growth of a child's kidney, but the number of sessions is kept as low as possible.
Preventing new stones and long-term follow-up
- Fluids: enough water through the day, including at school, so the urine stays pale. Send a water bottle to school and remind older children to drink during play and sport.
- Salt: limit chips, namkeen, instant noodles and packaged snacks.
- Calcium: do not stop milk, curd or paneer unless advised. Normal calcium intake helps protect against stones.
- Sugary drinks: replace soft drinks and packaged juices with water or lemon water.
- Medicines: potassium citrate or other medicines when tests show a specific cause; cystinuria needs its own lifelong plan.
- Infections and anatomy: treating urine infections promptly and correcting blockages or reflux.
Children who have had a stone are followed with ultrasound, usually every few months at first and then yearly, with repeat urine tests if the cause is metabolic. Stones that start in childhood can recur through adult life, so the habits learned now matter. Brothers and sisters may need checking when the cause is inherited.
Cost of kidney stone treatment for children in Jaipur
The clinic gives you a written estimate after the consultation and any scans, because the final bill depends on your own case. What changes the cost:
- The procedure chosen, such as ESWL, RIRS or Mini-PCNL, and whether pre-stenting is needed first
- General anaesthesia for the procedure and for stent removal
- Tests for the cause, such as stone analysis, urine collections and blood tests
- Whether an anatomical problem is corrected in the same operation
- The room category you choose at ManglamPlus Medicity and the number of nights
Insurance and government schemes
Most health insurance policies cover planned surgery of this kind, subject to their terms, such as waiting periods and room-rent limits. Whether you can go cashless depends on the hospital’s agreement with your insurer or TPA. Empanelment for government schemes such as RGHS, MAA Yojana, PM-JAY and CGHS belongs to the hospital, not the doctor, so please confirm your scheme with the ManglamPlus Medicity billing desk before admission.
Why Dr. Nitin Negi
Kidney stone treatment for children with Dr. Nitin Negi, urologist in Jaipur
- MCh super-specialistMBBS, MS (Surgery), MCh in Genitourinary Surgery; senior residency at AIIMS, New Delhi.
- 12+ years in urologyEndourology including RIRS, Mini-PERC, PCNL, HoLEP, TURiS and TURP; laser surgery since 2016.
- 150W Holmium laserAvailable at ManglamPlus Medicity for kidney stone and prostate surgery.
- Clear explanationsEvery option, risk and cost discussed before treatment; two Jaipur locations.
Frequently asked questions
Can a child pass a kidney stone without surgery?
Yes, small stones often pass, and children tend to pass stones and fragments more easily than adults. Your child is watched with ultrasound while drinking more fluids. A procedure is needed if the stone blocks the kidney, causes infection, keeps causing pain or grows.
Is general anaesthesia safe for my child?
Serious problems from anaesthesia are rare in healthy children. The anaesthetist checks your child beforehand, explains fasting times and stays throughout. Most children wake within minutes of the procedure ending and are drinking within a few hours.
Did we cause the stone by what we fed our child?
Usually not on its own. Diet and low fluid intake play a part, but many children with stones have a metabolic, infective or anatomical cause. The tests after treatment are meant to find it, so that the right changes can be made.
Are kidney stones in children hereditary?
Some causes run in families, such as cystinuria and some forms of high urine calcium. A family history of stones also raises the risk. When an inherited cause is found, brothers and sisters may be advised to have tests.
How much water should my child drink?
It depends on age, weight, the weather and activity. A practical guide is that the urine should stay pale yellow through the day. Your doctor can give a daily target based on the urine tests.
Will the stone damage my child’s kidney?
Most stones, treated in time, do not cause lasting damage. A stone that blocks the kidney for a long time, especially with repeated infections, can harm it. That is why blockage and fever are treated promptly and follow-up scans are kept.
Should my child stop drinking milk?
No, unless your doctor advises it for a specific reason. Normal amounts of milk, curd and paneer help bind oxalate in the gut and lower stone risk. Cutting calcium can make stones more likely.
This page is general information, not a diagnosis or a promise of any result. Please read our medical disclaimer.