Diagnostic and therapeutic aspects of cystine lithiasis
Burgos, F.J.; García-Cuerpo, E.; Lovaco, F.; Berenguer, A.
Archivos Espanoles de Urologia 40(6): 403-411
1987
ISSN/ISBN: 0004-0614 PMID: 3314741 Document Number: 295906
A study undertaken in 14 cystinuric patients (mean age 28,7 years, mean follow up 27 months) yielded the following data: 1) Only patients with urinary levels of cysteine > 200 mg/24 h/gr. creatinine have lithiasic activity. 2) Hypercalciuria and hyperuricouria are present in 14.2% of lithiasic patients. 3) The incidence of associated urinary infection is 14.2 whereas the incidence rate is 38% for mixed lithiasis. 4) Radiopaque lithiasis of a recurrent type in a young patient with a family history of lithiasis (57%) that has undergone multiple operations should suggest the diagnosis of cystinuria. 5) Diuresis > 3,000 ml/24 h, and 7.5-8 urinary pH are important in prophylactic therapy. 6) In situ irrigation with N-acetylcysteine (N-AC) through a drain nephrostomy has proved effective in dissolving multiple lithiasis in one patient.