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Suburban teen's monster kidney stone highlights growing health concern
By Robert McCoppin | Daily Herald Staff

Nicholas Knabusch, 16, of Algonquin shows the incision marks where doctors removed his kidney because it had been blocked by a huge kidney stone.

 

Daniel White | Staff Photographer

Urologic surgeon David Goldrath talks with Nicholas Knabusch and his mother, Patty, of Algonquin about his rare kidney disease.

 

Daniel White | Staff Photographer

Nicholas Knabusch, 16, of Algonquin shows the bear-shaped stone removed from his kidney.

 

Daniel White | Staff Photographer

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Published: 8/8/2008 12:13 AM

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When a nurse tells 16-year-old Nick Knabusch, "You've been through a lot, haven't you?" he just shrugs.

But when he lifts his shirt for a doctor, he reveals five sealed incisions, each about a centimeter long. The healing wounds are where a doctor and a robot reached in to remove his dead right kidney and the monster kidney stone that killed it.

Nick, a student at Jacobs High School in Algonquin, had never had any symptoms to alert him to a such a serious condition.

But after he woke up on a recent morning doubled over in pain, he soon learned he was part of a small but growing number of children who suffer from kidney stones.

The heat of summer, changing diets and even global warming are thought to be contributing to an increase in the number of kidney stones in the Chicago area, with researchers predicting 100,000 more cases in the area annually by 2050.

Apart from environmental factors, it turns out Nick has a rare genetic condition that forms large stones in his kidneys. Normal kidney stones are the size of a grain of sand and cause pain that has been compared to the pain of childbirth, but Nick's stone was half the size of a golf ball.

Now he must take special steps to save his one remaining kidney, to fight a condition that strikes only 1 in 200,000 people.

Or as he joked when he heard the news, "It's like winning the lottery."

Dr. David Goldrath at Advocate Good Shepherd Hospital near North Barrington diagnosed Nick on Thursday with cystinuria, a rare inherited disease that prevents the body from eliminating the amino acid cystine and forms rock-hard lumps.

Nick can live a full life with one kidney, his doctor told him, but he should stay away from contact sports and his passion for dirt bikes.

While it is rare for children to have kidney stones, Nick is not alone. In 2006, Johns Hopkins University reported a worrisome increase in kidney stones among children.

The main cause is thought to be poor diet: too much salt and not enough liquids.

In Nick's case, he has to go on a low sodium diet, and to help his body break down the cystine, he has to take potassium citrate and drink three to four liters of water a day. He'll have to undergo periodic tests to check for kidney stones, to fight what is typically a lifelong condition.

Because cystinuria is a genetic disorder, Nick's 13-year-old brother and his cousins will have to get tested to see if they too have inherited it.

His mother, Patty, is still trying to get Blue Cross/Blue Shield to pay for the operation with the robot, which it considers experimental.

She tries to make light of the situation, carrying the bear-shaped kidney stone in a vial in her purse and showing it to those she meets.

But in a more serious mood she admits, "It's going to be a big change in his life."