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Kidney Stones

Update in Diagnosis and Management



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Cystine Stones

Slide 25

February 2010

Cystine stones are only seen in patients with cystinuria, a genetic disorder in which transporters in the proximal tubular which reabsorbed filtered amino acids are not functioning normally. Although urinary levels of other dibasic amino acids are also high, the patients develop cystine stones because cystine is not very soluble in urine.

The mainstay of treatment is forced diuresis by drinking copious amounts of fluids. Low sodium and protein intake can marginally reduce urinary cystine excretion, and cystine is somewhat more soluble in alkaline urine. D-penicillamine and thiola are 2 drugs which can complex cystine to increase its solubility. However, both have potential side effects so are reserved for patients that fail other more conservative measures.

Cystine Stones

 


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