Children’s Hospital of Philadelphia’s Pediatric Kidney Stone Center offers shockwave lithotripsy to remove kidney stones. www.chop.edu/kidneystonecenter

In this video:
[0:07] Chloe’s kidney stone diagnosis
[0:37] Common symptoms of pediatric kidney stones
[1:00] Importance of an experienced, interdisciplinary team
[1:20] Importance of partnering with patients and caregivers
[1:38] Treatment options for kidney stone removal
[2:21] Chloe’s experience with ureteroscopy and stone recurrence
[3:04] What is shockwave lithotripsy?
[4:08] Chloe’s experience with shockwave lithotripsy
[4:35] A parent’s perspective on the Pediatric Kidney Stone Center
[5:09] Improving understanding, prevention, treatment and outcomes of pediatric kidney stones

In this video, Chloe and her mother, Rachel, discuss Chloe’s experience with kidney stones and what it was like to undergo the shockwave lithotripsy procedure at Children’s Hospital of Philadelphia (CHOP).

Normally, urine contains many dissolved materials. If these materials become concentrated in the urine, they can form solid crystals that can lead to the development of small, hard deposits of minerals (called kidney stones) that can form inside the kidneys or ureter (the tube that connects the kidney to the bladder).

Kidney stone disease (also called nephrolithiasis) can have a tremendous impact on quality of life. It can cause blood in the urine, pain, nausea, vomiting and fever and block the drainage of urine. Kidney stones are associated with a higher risk of high blood pressure, heart disease, loss of kidney function, and lower bone mineral density leading to fractures.

Unfortunately, kidney stones are becoming more common in children. The likelihood that a child will develop a kidney stone has doubled over the last 25 years. Until recently, children with kidney stones were primarily treated in adult healthcare settings. Studies have shown, however, that specialized care for children with stones improves patient outcomes.

In 2014, to meet the rising need for specialized kidney stone treatment for children, Children’s Hospital of Philadelphia (CHOP) established the Pediatric Kidney Stone Center. The center offers integrated, stateoftheart care for infants, children, adolescents, and young adults with kidney stone disease.

The center uses a multidisciplinary approach that includes care from pediatric urologists, pediatric nephrologists, radiologists, interventional radiologists, emergency room physicians, nurse practitioners, physician's assistants, nurses, and dietitians.
Today, children and adolescents from across the United States and world travel to CHOP's Pediatric Kidney Stone Center for care.

The center offers three treatment options to remove kidney stones: shockwave lithotripsy (SWL), ureteroscopy and percutaneous nephrolithotomy (PCNL). This video takes an indepth look at lithotripsy, including a detailed account from Rachel and Chloe and expert insight from expert pediatric urologist Gregory E. Tasian, MD, codirector of the center.

Chloe underwent ureteroscopy surgery twice to remove kidney stones before undergoing shockwave lithotripsy. Shockwave lithotripsy is a noninvasive procedure done under general anesthesia. During the procedure, the kidney stone is visualized using ultrasound, an imaging method that does not use radiation. Then, a machine called a lithotriptor is used to generate shockwaves that are focused on the stone. The pulse from the shockwaves breaks the stone into very small particles that are then able to be passed spontaneously in the urine. Shockwave lithotripsy is an outpatient procedure, meaning that after recovering from surgery for a few hours, a child can go home; they do not need to stay at the hospital overnight.

During the procedure, stone fragments are extracted and sent to a lab for analysis. Knowing the stone’s composition is critical to understanding what type of stone it is and what measure can be used to prevent the stone from coming back.

The team at CHOP’s Kidney Stone Center believes in partnering with patients and their caregivers to determine which surgery is best. The team explains the treatment options and then partners with families to help them make the most informed decision possible.
In addition to removing existing stones, the center’s team tries to prevent future kidney stones. Patients return for followup every six months for metabolic testing and an ultrasound to help the team understand what factors are driving stone formation. The team partners with families to create a longterm prevention plan.

The center team is involved in ongoing research efforts dedicated to better understanding why kidney stones are occurring earlier in life and the factors that lead to kidney stones in children.

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