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You have diagnosed a 14 year old boy with likely nephrolithiasis, as evidenced by his colicky flank pain, hematuria, and ultrasound showing mild hydronephrosis.
Kelly September 10, 2019 - 10:23 pm
D) Limit milk intake and other sources of calcium
Nephrolithiasis in pediatrics is on the rise, and poor diet and increasing obesity may be playing a role. Calcium stones are the most common type of pediatric kidney stone. High sodium intake increases urinary excretion of calcium. Excessive protein intake results in an acid load from protein metabolism that increases hypercalciuria. Adequate fluid intake helps decrease urinary supersaturation of calcium, oxalate, and uric acid; recommendations are for intake > 1 L/day in 1.5 L in 5-10yo, and > 2 L in > 10yo. A ketogenic diet increases the risk of uric acid stones. Limiting calcium intake is not recommended because it can increase oxalate absorption and risk of oxalic acid stones, and because calcium is important for bone health in growing children.