Kidney sand in children causes symptoms and effective treatment methods

Kidney sand in children is a common health issue that can often go unnoticed by parents at first. However, if left untreated, it can lead to severe pain and complications later on. Kidney sand not only affects the urine and kidneys but can also impact a child’s daily activities and growth. In this Dalily Medical article, we’ll discuss the causes of kidney sand in children, the key symptoms to watch for, and the best treatment options—whether through medications, surgery, exercises, or natural herbs. We’ll also provide important tips to prevent kidney sand from forming again.

1️⃣ What is kidney sand in children?
Kidney sand is the first stage of kidney stone formation in children. It occurs when salts and minerals accumulate in the kidneys before forming larger stones. Early detection is important to prevent complications.

2️⃣ Symptoms of kidney sand in children

Pain in the abdomen, back, or sides.
Frequent urination or pain during urination.
Dark-colored urine or sometimes blood in the urine.
Nausea or vomiting in some cases.

3️⃣ Causes of kidney sand in children

Not drinking enough water or fluids.
High salt or protein intake leading to excess minerals in the urine.
Genetic factors or a family history of kidney stones.
Certain chronic illnesses or kidney problems.

4️⃣ Types of kidney sand in children

Calcium oxalate sand – the most common type.
Calcium phosphate sand.
Uric acid sand.
Potassium citrate sand – less common.

5️⃣ Complications of untreated kidney sand

Formation of larger kidney stones.
Blockage of the urinary tract.
Recurrent urinary tract infections.
Persistent pain or long-term kidney function deterioration.

6️⃣ Diagnosis of kidney sand

Ultrasound (sonography) of the kidneys and bladder.
Urine tests to detect salts, blood, or infection.
Blood tests to monitor kidney function and mineral levels.

7️⃣ Can kidney sand go away?
Yes, with sufficient water intake, dietary adjustments, and regular medical follow-up, the sand can decrease before forming stones.

8️⃣ Treatment of kidney sand in children

Drink plenty of fluids throughout the day.
Medications to dissolve salts or adjust urine pH according to the type of sand.
Adjust the diet to reduce excess salt and protein.
Regular medical follow-up to prevent stone formation.

9️⃣ Importance of prevention
Prevention is very important as it stops kidney sand from turning into larger stones. Key measures include:

Drinking enough water daily.
Following a healthy and balanced diet.
Regular check-ups with a pediatric nephrologist.

Stages of kidney sand in children
1️⃣ Deposition or early stage
Salts and minerals like calcium or oxalate start forming tiny crystals in the urine.

Stages of Kidney Sand in Children

1️⃣ Early deposition stage
At this stage, the child usually has no noticeable symptoms. Kidney sand may be discovered incidentally through a urine test or ultrasound.

2️⃣ Sand formation stage
Tiny crystals start to aggregate, forming visible “sand.”
Symptoms may appear, such as mild abdominal or back pain, frequent urination, and sometimes blood in the urine.

3️⃣ Small stone formation stage
The sand begins to accumulate into small stones that may move within the kidney or ureter.
Pain may increase, especially when the stone moves, causing recurrent renal colic.

4️⃣ Large stones or complication stage
Large stones may block the urinary tract.
There is a risk of recurrent kidney infections, gradual kidney damage if left untreated, or high blood pressure in some cases.

Causes of Kidney Sand in Children

Kidney sand in children appears due to the accumulation of salts and minerals in the urine before forming stones. The causes are varied and related to dietary, genetic, and other health factors:

1️⃣ Dehydration and insufficient water intake
Low fluid intake makes the urine concentrated, increasing salt and mineral deposition such as calcium, oxalate, and urea.
This accumulation is the starting point for sand formation.

2️⃣ Dietary factors

Foods high in salt or animal protein.
Foods rich in oxalates such as spinach, chocolate, and nuts.
Excessive sugar or carbonated drinks.

3️⃣ Genetic and structural factors

Family history of kidney stones or kidney problems.
Certain inherited kidney diseases, such as polycystic kidney disease or kidney function disorders.
Metabolic disorders causing increased calcium or uric acid in the urine.

4️⃣ Urinary tract infections
Frequent infections alter urine pH, promoting salt deposition and sand formation.

5️⃣ Medications or supplements

Some calcium or vitamin D supplements without medical supervision.
Diuretics or medications for chronic diseases may increase salt accumulation in the kidneys.

Types of Kidney Sand in Children

The type of kidney sand depends on which salts and minerals are accumulating:

1️⃣ Calcium sand

The most common type in children.
Caused by high calcium in the urine or foods rich in calcium and oxalate.
May be associated with dehydration or high animal protein intake.

2️⃣ Uric acid sand

Results from high uric acid levels in blood and urine.
Causes: foods rich in red meat or fish, dehydration, or certain metabolic disorders.

3️⃣ Phosphate sand

Results from calcium phosphate or ammonium deposition.
Causes: chronic urinary tract infections or abnormal urine pH.

4️⃣ Struvite sand

Linked to bacterial urinary tract infections.
Often accompanied by recurrent infections; treating the infection is necessary to reduce deposition.

5️⃣ Cystine sand

Very rare, caused by a genetic disorder called Cystinuria.
Occurs due to a defect in reabsorbing certain amino acids in the kidneys.

Diagnosis of Kidney Sand in Children

Accurate diagnosis is essential, especially in the early stages when the child may show no symptoms. Diagnosis usually involves several tests:

1️⃣ Medical and family history

Questions about previous kidney problems or stones in the child or family.
Monitoring symptoms like abdominal or back pain, frequent urination, or blood in urine.

2️⃣ Clinical examination

Examination of the abdomen and back to check for tenderness or kidney swelling.
Blood pressure measurement, particularly if there is a history of kidney disease, as high pressure may be an early sign of complications.

3️⃣ Laboratory tests

Urine analysis: to detect blood, protein, or crystals.
Blood tests: to monitor kidney function and levels of calcium, phosphorus, and uric acid.

4️⃣ Imaging Tests

Ultrasound: The easiest and most important test to detect kidney sand or small stones, and to monitor their size and location.
CT scan: Used if the ultrasound is unclear or in complex cases, to determine the exact size of the stones.
IVP (Intravenous Pyelogram): Rarely used; it shows the shape of the urinary tract and urine flow.

Symptoms of Kidney Sand in Children

Symptoms can vary depending on the size and location of the sand, and whether it is causing obstruction or infection. Key symptoms include:

1️⃣ Pain-related symptoms

Mild to moderate pain in the abdomen or lower back.
Sometimes intermittent pain that worsens with movement or urination.
If the urinary tract is blocked, pain can be severe and sudden (Renal Colic).

2️⃣ Urination-related symptoms

Frequent urination or a sudden urge to urinate.
Painful urination or burning sensation.
Change in urine color: sometimes blood appears due to friction of sand against the kidney or ureter wall.

3️⃣ General symptoms

Nausea or vomiting in some cases.
Slight fever if a urinary tract infection is present.
Fatigue or irritability in younger children.

4️⃣ Chronic symptoms when sand accumulates

Formation of larger stones over time.
Growth delays in children if kidney sand causes ongoing kidney problems.
Occasionally high blood pressure if kidney function is affected.

???? Advice: Any child showing blood in the urine or recurrent abdominal or back pain should be evaluated by a pediatric nephrologist and undergo an ultrasound to determine the size of the sand and presence of stones.

Medical Treatment of Kidney Stones in Children

Treatment with medications varies depending on the type, size, and location of the stone. The main goals are: relieving pain, breaking down sand or small stones, and preventing new stones from forming.

1️⃣ Pain relief

Use safe painkillers for children such as paracetamol or ibuprofen, according to the child’s age and weight.
The goal is to control pain, especially when the stone moves in the ureter.

2️⃣ Increasing passage of small stones

Drinking plenty of fluids to facilitate the passage of small stones (sand).
Sometimes mild diuretics are prescribed under medical supervision to help pass stones.

3️⃣ Treating the cause of stone formation

If stones are due to high calcium in the urine: medications may be prescribed to reduce calcium excretion.
If caused by uric acid: medications like allopurinol may be used if needed.
If there are recurrent urinary tract infections: appropriate antibiotics are prescribed based on culture results, as infections can increase the risk of stone formation.

4️⃣ Preventing new stones

Adjust the diet according to the type of stone:
- Reduce salt or excess animal protein if linked to certain stones.

Increasing Fluid Intake

Drinking plenty of water consistently is essential.
Sometimes, doctors may prescribe supplements or medications to prevent mineral deposits in the urine, depending on the type of stone.

5️⃣ Follow-up for the Child

Regular urine and kidney tests to check for new stones or mineral buildup.
Periodic ultrasound to monitor the size and location of stones.

Surgical Treatment of Kidney Stones in Children

Surgery is necessary when medications or conservative treatment are insufficient, especially if the stone is large, blocking the ureter, or causing complications.

1️⃣ Lithotripsy (Stone Fragmentation)

Extracorporeal shock wave lithotripsy (ESWL): Shock waves break the stone into small pieces that can pass easily with urine.
Suitable for small to medium-sized stones.
Minimally invasive and requires brief anesthesia in children.

2️⃣ Ureteroscopy

A small scope is inserted into the ureter or kidney to remove or laser-fragment the stone.
Suitable for stones located in the ureter or kidney.
Requires general anesthesia and is less invasive than open surgery.

3️⃣ Open Surgery

Very rare in children but necessary for very large or complex stones that cannot be treated by other methods.
The stone is removed directly from the kidney or ureter.
Requires close postoperative monitoring.

4️⃣ Post-Surgery Care

Monitor kidney function and urine output.
Follow up on blood pressure and growth.
Periodic ultrasound to ensure no new stones form.
Continue conservative treatment to prevent recurrence (adequate fluids, medications according to stone type).

Benefits of Exercise for Children with Kidney Sand or Stones

Moderate physical activity is very important for protecting kidney health in children because it reduces the complications of sand or stone formation:

1️⃣ Improves Urine Flow

Physical activity stimulates body and urine movement, reducing urine stagnation that increases stone formation risk.

2️⃣ Weight Management

Obesity increases pressure on the kidneys and alters mineral concentration in urine. Exercise maintains a healthy weight and reduces kidney stress.

3️⃣ Improves Circulation and Blood Pressure

Regular activity helps regulate blood pressure, important because high blood pressure can worsen kidney problems.

4️⃣ Supports Overall Growth and Mental Health

Exercise improves appetite and sleep and reduces stress in children with chronic health issues.

Recommended Types of Exercise

Walking and outdoor play.
Light running and jumping rope.
Swimming (if approved by a doctor).
Light motor games and floor exercises.

⚠️ Precautions

Avoid strenuous exercise or weightlifting if there is kidney weakness or blood pressure issues.
Any exercise program should be supervised by a doctor or specialist, especially for children with kidney problems.

Herbs Beneficial for Children’s Kidneys and Stones

1️⃣ Parsley

Natural diuretic that helps flush out minerals and sand.
Can be prepared as a mild tea for children after consulting a doctor.

2️⃣ Celery

Acts as a diuretic and reduces mineral buildup in the kidneys.
Can be added to meals or made into a mild tea.

3️⃣ Horsetail (Equisetum)

Diuretic that helps cleanse the kidneys.
Use with caution and only for a short period.

4️⃣ Lemon and Citrus Juices

Increase urine citrate, which prevents some types of stones.
Small amounts of lemon juice can be added to water for children.

5️⃣ Ginger and Mint

Reduce inflammation and improve urine flow.

Preventive Tips for Children to Avoid Kidney Stones

Prevention is always better than treatment, especially for children prone to kidney sand or stones. Key tips:

1️⃣ Drink Adequate Water

The most important preventive factor.
Children should drink 6–8 cups of water daily, depending on age and weight.
Water dilutes urine minerals and prevents deposition in the kidneys.

2️⃣ Avoid Soft Drinks and Artificial Juices

These drinks contain sugars and acids that increase stone formation risk.

3️⃣ Balanced Diet

Reduce salty foods (excess salt increases urine minerals).
Limit excessive animal protein (meats, cheeses) according to doctor’s advice.
Increase fresh vegetables and fruits rich in fiber and vitamins.

4️⃣ Encourage Physical Activity

Walking, outdoor play, swimming.
Activity reduces mineral buildup and strengthens kidney blood flow.

5️⃣ Monitor Family History

If there is a family history of kidney stones, regular screening for the child is necessary.

6️⃣ Maintain a Healthy Weight

Excess weight increases kidney pressure and affects function.

7️⃣ Avoid Certain Medications or Supplements Without Medical Advice

Some vitamins or supplements may increase the risk of stone formation.

⚠️ Complications of Untreated Kidney Sand in Children

If kidney sand or small stones are left untreated, they can cause serious short- and long-term problems, depending on size, location, and impact on the kidneys and urinary system:

1️⃣ Urinary Tract Obstruction

Sand can accumulate and block the ureter or bladder.
Obstruction leads to urine buildup in the kidney (hydronephrosis) and increased pressure on kidney tissue.

2️⃣ Recurrent Urinary Tract Infections

Presence of sand or stones increases bacterial growth.
Recurrent infections may cause fever, severe pain during urination, and sometimes acute kidney infection (Pyelonephritis).

3️⃣ Decline in Kidney Function

Continuous pressure from obstruction or chronic infections can reduce the kidney’s filtering capacity.
Over time, progressive kidney failure may occur.

4️⃣ Severe Pain and Behavioral Complications