Medically reviewed by: Dr. Anthony Kallas Chemaly
Last reviewed: April 5, 2026
Sources used on this page: trusted clinical references and pediatric-hospital resources listed below.
What Are Pediatric Kidney Stones?
Kidney stones (nephrolithiasis) are hard mineral deposits that form in the kidneys or urinary tract. While traditionally considered an adult condition, kidney stones in children have become increasingly common over the past two decades. The rise is linked to changes in diet — particularly higher sodium and lower fluid intake — as well as increasing rates of childhood obesity. Kidney stones can occur at any age, including in infants and toddlers, and may affect one or both kidneys. The most common type in children is calcium oxalate, though the composition varies and identifying it is important for prevention.
Signs and Symptoms
In older children and adolescents, kidney stones typically cause sudden, severe pain in the flank (side) or lower abdomen, often radiating to the groin. The pain may come in waves (renal colic) and is frequently accompanied by nausea or vomiting. Blood in the urine (hematuria) — visible or microscopic — is another common sign. In younger children and infants, symptoms may be less specific: irritability, vomiting, or recurrent urinary tract infections may be the only clue. Some stones are discovered incidentally on imaging performed for other reasons.
How Are Kidney Stones Diagnosed?
Diagnosis begins with a thorough history, physical examination, and urine analysis. Ultrasound is the preferred first-line imaging study in children because it avoids radiation exposure and reliably detects stones in the kidneys and proximal ureter. In cases where ultrasound is inconclusive or the stone location needs precise definition before surgery, a low-dose CT scan may be used. Blood tests help assess kidney function and identify metabolic abnormalities. After the acute episode, a complete metabolic evaluation — including 24-hour urine collection — is essential to determine why the stone formed and how to prevent recurrence.
Treatment Options
Treatment depends on the size, location, and symptoms caused by the stone. Small stones (generally under 5 mm) may pass spontaneously with increased fluid intake and pain management, sometimes aided by medication to relax the ureter (medical expulsive therapy). For larger stones or those causing obstruction, infection, or persistent pain, surgical intervention is needed. The two primary minimally invasive options are ureteroscopy (URS) with laser lithotripsy — where a thin scope is passed through the urinary tract to fragment the stone with a laser — and extracorporeal shock wave lithotripsy (ESWL), which uses focused sound waves from outside the body to break the stone into passable fragments. For very large or complex stones, percutaneous nephrolithotomy (PCNL) may be considered. The choice of technique depends on the individual case.
Prevention and Metabolic Evaluation
Children who have had one kidney stone have a recurrence rate that may exceed 50% without preventive measures. This makes metabolic evaluation after the first stone episode critically important. A 24-hour urine collection and blood tests can reveal conditions such as hypercalciuria, hyperoxaluria, hypocitraturia, or cystinuria — all of which increase stone risk and are treatable. Prevention strategies typically include significantly increasing daily fluid intake (the single most effective measure), reducing dietary sodium, moderating animal protein consumption, and ensuring adequate calcium intake through food (not supplements). In some cases, specific medications such as potassium citrate may be prescribed. Regular follow-up with a pediatric urologist ensures that the prevention plan is working.
Dr. Kallas Chemaly's Approach
Dr. Kallas Chemaly combines minimally invasive surgical expertise with a comprehensive metabolic workup to treat the stone and address the underlying cause. He uses the latest ureteroscopy and laser lithotripsy techniques, ensuring effective stone clearance with minimal discomfort and rapid recovery. For every child, he initiates a thorough metabolic evaluation to identify preventable risk factors and develops a personalized prevention plan. His fellowship training at three European centers of excellence — Robert-Debré (Paris), Queen Fabiola (Brussels), and HFME (Lyon) — equips him to manage even complex and recurrent stone disease in children. He explains every step to parents in Arabic, French, or English, ensuring families feel informed and confident.
References
Serving families across Beirut and Mount Lebanon
Dr. Kallas Chemaly treats Pediatric Kidney Stones in Lebanon in children from Achrafieh, Gemmayzeh, Saifi, Sodeco, Verdun, Hamra, Clemenceau, Ras Beirut, Rabieh, Mtayleb, Brummana, Beit Mery, Bikfaya, Mansourieh, Kornet Chehwan, Antelias, Dbayeh, Jounieh, Kaslik, Hazmieh, Yarze, and across Keserwan, Metn, and Baabda.