Breakthrough Research Supports Precision Surgical Treatments for Pediatric Kidney Stones

Recent findings from the Pediatric KIDney Stone (PKIDS) trial, conducted by researchers at Children's Hospital of Philadelphia (CHOP) alongside several academic partners, highlight significant advancements in the surgical management of kidney stones in children and adolescents. This large-scale study, with primary results published in JAMA Network Open, provides comprehensive evidence comparing various surgical approaches, aiming to improve treatment efficacy and patient quality of life.

The PKIDS trial, the most extensive of its kind, involved the enrollment of 1,142 patients aged 8 to 21 across 31 sites in the United States and Canada from 2020 to 2023. The study focused on evaluating the effectiveness and patient recovery experiences associated with three main procedures: ureteroscopy (an outpatient endoscopic technique), shockwave lithotripsy (a noninvasive outpatient method), and percutaneous nephrolithotomy (a minimally invasive surgery often requiring short hospital stays).

Traditionally, ureteroscopy is the treatment of choice for pediatric kidney and ureteral stones, but its relative effectiveness compared to other procedures had been uncertain. The PKIDS trial revealed that shockwave lithotripsy results in less post-surgical pain and urinary symptoms, with similar stone removal rates compared to ureteroscopy, suggesting it as a favorable option when appropriate. Additionally, for larger stones, percutaneous nephrolithotomy demonstrated superior stone clearance and a more comfortable recovery experience.

The researchers emphasized that beyond stone removal success, post-operative quality of life factors such as school and work disruptions are vital considerations in treatment planning. The findings aim to guide physicians, caregivers, and patients toward more tailored and effective decision-making processes.

Dr. Gregory E. Tasian, leading the PKIDS network, commented that these results support a more patient-centered approach by identifying options that not only focus on stone removal but also prioritize recovery and overall well-being. The study underscores the importance of integrating patient experiences into clinical practice guidelines and encourages ongoing research to refine pediatric kidney stone management.

This study signifies a pivotal step forward in pediatric urology, promoting personalized treatments and improved outcomes for young patients affected by kidney stones.

For more detailed information, the studies are available in JAMA Network Open:

• Ureteroscopy vs Shockwave Lithotripsy: [DOI: 10.1001/jamanetworkopen.2025.25789]
• Percutaneous Nephrolithotomy vs Ureteroscopy: [DOI: 10.1001/jamanetworkopen.2025.16749]

Source: https://medicalxpress.com/news/2025-08-surgical-interventions-children-adolescents-kidney.html