Mumbai: Kidney stones, once considered a problem of the grown-ups, is now showing up in children as young as two years old.
Ask Powai residents Minal and Mehul Joshi (names changed), who were “shellshocked’’ when doctors recently told them 18-month-old Yash’s frequent bouts of urinary tract infection had resulted in the formation of a complex stone, Staghorn calculi, in his kidneys. “One has always associated kidney stones with uncles and grandfathers. Moreover, it seemed that the condition was easy to resolve with medicines. But we were devastated to learn our son needed a procedure to get rid of stones that had developed in both his kidneys,’’ says Minal.
The mother believes it’s poor water intake that worsened her son’s plight. However, a study released in the Journal of Pediatrics in April 2010 enumerates how a host of lifestyle reasons — from increased intake of salt, lowered intake of milk, obesity and changed usage of antibiotics — doubled the incidence of kidney stones in children in US’ South Carolina between 1996 and 2007. As there are no local studies on paediatric kidney stones, doctors here give varied opinions but acknowledge it’s a cause for concern.
The Mumbai-based Paediatric Oncall journal says “kidney stones are not very common in children, but these stones are being discovered now with increasing frequency amounting to up to one in each 1,000 childhood admissions.’’ Paediatric urologist Dr Arbinder Singhal, who operated on 18-month-old Yash using an endoscopic technique, said: “We have been seeing about seven to eight children with kidney stones every month for the last year.’’ He feels it is a measure of the growing incidence in the paediatric population that an endoscopic technique called percutaneous nephrolithotomy (Perc) that was used for grownups was recently improvised for use in children (Mini Perc).
Paediatric nephrologist Dr Pankaj Deshpande says he has seen infants as young as six months old with stones. “We are definitely seeing more children than before,’’ he adds.
Most kidney stones occur when oxalate, a byproduct of some foods, binds to calcium in the urine. Other common stones are calcium phosphate stones and uric acid stones. American researchers feel that the binding process is enhanced when children don’t drink enough fluids and eat foods with high salt content. A New York Times article quoted Dr Bruce L Slaughenhoupt from the University of Wisconsin as saying “it is not just salty chips and French fries, but also processed foods like sandwich meats; canned soups; packaged meals; and even sports drinks like Gatorade’’ that led to stones in children.
While no such reasons are established in India, Dr Deshpande feels the only lifestyle reason he would identify is the rampant use of calcium supplements. “Another reason could be better availability of technology. A decade back, an ultrasound screening wasn’t as frequently prescribed as it is today for children,’’ he says. However, Dr N K Hase, who heads the nephrology department of KEM Hospital, doesn’t feel that the number of paediatric kidney stone cases has gone up significantly