Those who have endured a kidney stone often describe the ordeal as an incredibly painful experience — a 10 out of 10 on the pain scale. Unfortunately, that agony is common. About one in 10 people will develop a kidney stone in their lifetime.
Despite their prevalence, much remains unknown about why kidney stones form, and treatments have largely remained the same for over 50 years. Now, researchers at the Indiana University School of Medicine are bringing kidney stone mysteries to the forefront and investing in innovative strategies to modernize treatments, especially for children.
Kidney stones are pebble-like objects that form in the kidneys and pass through the urinary tract. Common symptoms include sharp abdominal pain, nausea, vomiting, urination complications, fevers or chills. While smaller stones can typically pass naturally, larger stones may require medical assistance to be broken down or removed. Symptoms often present quickly and should be taken seriously by consulting a physician if there is extreme pain.
“Kidney stones are common, and they cause a lot of discomfort, but they cause problems beyond discomfort,” said Andrew Schwaderer, MD, a professor of pediatrics at the IU School of Medicine and a pediatric nephrologist at Riley Children’s Health. “Problems with the kidneys, the heart, blood vessels and bones all occur in kidney stone patients, yet new treatments have not been developed for decades.”
As a kidney and urology research expert at the Herman B Wells Center for Pediatric Research, Schwaderer is eager to address the growing rates of kidney stones occurring worldwide.
“A major misconception about kidney stones is that kids don't get them, but they're an increasing problem in pediatrics,” he shared. “We’ve noticed about a threefold increase in female adolescents over the last 20 years.”
While many questions remain, certain factors contributing to kidney stones are well established, including family history. A child with a first- or second-degree relative who had a kidney stone is more likely to develop one, too. Another factor is hypohydration, a state that occurs when the body lacks enough fluids.
“Picture a flowing mountain stream versus a swamp,” Schwaderer explained. “Someone with hypohydration has urine that’s more like a swamp — very low flow, very concentrated.”
Another significant contributor to kidney stones includes the combination of crystals, proteins and bacteria. While crystal-like substances are the most apparent part of a stone’s makeup, research led by Schwaderer is among the first to demonstrate in a lab model that proteins and bacteria found in the immune system combine with those crystals to help kidney stones form.
With support from collaborators at IU and Loyola University Chicago, Schwaderer is leading a new study funded by the National Institutes of Health to uncover the root causes of kidney stones.
“We've developed a system where we can look at the interaction of those three components,” Schwaderer said. “We're trying to find out what in those prevents kidney stones and what forms them.”
Current treatments focus primarily on preventing crystals, not the combination of all the other factors that may be contributing to the issue and leading to additional health problems. Schwaderer’s new study takes a more holistic approach. His team has even developed an artificial kidney stone created in the lab to better analyze stone configuration and prevention.
As the research team works on new medical interventions, Schwaderer said there are still ways families concerned by kidney stones can take steps toward prevention. Dietary modifications should focus on healthy, whole foods. Drinking plenty of water, avoiding excessive or inadequate calcium intake, and limiting dietary sodium are important as well.
Ultimately, Schwaderer hopes to give this growing health concern the attention he believes it deserves.
“Kidney stones are a problem across the lifespan, but we still use the same medicines that we had in the ’70s,” he said. “I don't think there’s been anything new, and we’re past due for that to change.”
