PKIDS Care Improvement Network Resources

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For general inquiries about the Pediatric KIDney Stone (PKIDS) Care Improvement Network, please contact us. A list of frequently asked questions also is available below.

What are kidney stones?

Normally, urine contains many dissolved substances. At times, some substances may become concentrated in the urine and form solid crystals. These crystals can lead to the development of stones. Most kidney stones contain calcium, specifically, calcium oxalate. Other types of stones contain minerals such as calcium phosphate, uric acid, cystine, and struvite.

What treatment options exist for kidney stones?

Many factors must be considered in the diagnosis, management, and treatment of children with kidney stones. Treatment options may include medications, dietary therapy, nutritional assessments and counseling, and surgery.

Surgery may be needed if a stone:

  • Does not pass within a few weeks, a fever develops, or causes unbearable pain
  • Is too large to pass on its own
  • Blocks the flow or urine
  • Causes urinary tract infections
  • Damages the kidney or causes recurrent bleeding
  • Has grown larger (as seen on follow-up X-ray studies)

We use several procedures to break up and remove kidney stones. These procedures include: shockwave lithotripsy (SWL), ureteroscopy (URS), and percutaneous nephrostolithotomy or nephrolithotomy (PCNL).

Many patients who undergo URS, SWL, or PCNL also have temporary tubes placed after the surgery to facilitate drainage, either internally (a stent) or externally (a nephrostomy tube).

What is shockwave lithotripsy (SWL)?

SWL is a noninvasive outpatient procedure that targets stones in the kidney or ureter with X-ray or ultrasound and uses shockwaves generated outside the body to fragment them; the fragments pass down the ureter, and the patient expels them in the urine.

What is ureteroscopy (URS)?

URS is an outpatient endoscopic surgery that accesses the ureters and kidneys per the urethra to fragment and remove the stones. A laser is often used to remove or break up (fragment) stones.

What is percutaneous nephrostolithotomy or nephrolithotomy (PCNL)?

PCNL is a minimally invasive surgery in which a ~1cm flank incision is made, and a scope is passed through a tubular sheath into the kidney to fragment and remove the stone. There is typically a one- to two-day hospital stay.

What is patient-centered research?

"Patient-centered outcomes research (PCOR) helps people and their caregivers communicate and make informed healthcare decisions, allowing their voices to be heard in assessing the value of healthcare options," according to the Patient-Centered Outcomes Research Institute (PCORI). For more information on PCORI, please see their website.

What is a learning health system?

"A learning health system is a system in which internal data and experience are systematically integrated with external evidence, and that knowledge is put into practice," according to the Agency for Healthcare Research and Quality (AHRQ). "As a result, patients get higher quality, safer, more efficient care, and health care delivery organizations become better places to work." For more information on learning health systems, please see the AHRQ website.

Links of Interest

Joining PKIDS

  • Considerable criteria to join PKIDS (among others)
    • Annual pediatric stone case volume
    • Adequate support for a research coordinator for PKIDS activities
    • Experience in performing prospective cohort studies or clinical trials and/or track record of external funding leading to peer-reviewed publications
  • Consideration of New Research

Current Publications