Clinical Outcomes for Cystinuria Patients with Unilateral Versus Bilateral Cystine Stone Disease

Usawachintachit, Manint; Sherer, Benjamin A.; Hudnall, Matthew; Tzou, David T.; Taguchi, Kazumi; Hsi, Ryan S.; Stoller, Marshall L.; Chi, Thomas

doi:10.1089/end.2017.0335

Cited by 11 publications

(12 citation statements)

References 19 publications

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“…Median age of first clinical event was 13 years in a European cohort 8 and 16 years in a French study 17 although the diagnosis can also be made during adulthood 8,12,17,[29][30][31] . Type A and type B cystinuria have a similar age at diagnosis and similar clinical evolution 8,30 .…”

Section: A Clinical Presentationmentioning

confidence: 99%

Cystinuria: clinical practice recommendation

Servais¹,

Thomas²,

Strologo³

et al. 2021

Kidney International

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Section: A Clinical Presentationmentioning

confidence: 99%

Cystinuria: clinical practice recommendation

Servais¹,

Thomas²,

Strologo³

et al. 2021

Kidney International

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show abstract

“…5 studies reported various stone positions from unilateral, bilateral, left and right kidney, calyceal, pelvic and ureteral cystine stones. 17, 19, 30, 32, 33 Bilateral cystine stones were associated with a higher number of lifetime stone surgeries than unilateral stones (6.5 vs 2 sessions, p <0.05). 33 Stones were found in the left (46%) and right (54%) kidney.…”

Section: Resultsmentioning

confidence: 94%

“…10, 17-20, 23-28, 31, 32, 34-38, 40 Of the 24 studies, 5 reported median patient age, which ranged from 6 to 18.5 years. 11, 29, 30, 33, 39…”

Section: Resultsmentioning

confidence: 99%

“…Of the 20 studies, 13 reported detail about intervention type, stone position, intervention procedure, stone free rate and stone recurrence rate (Table 6). 10, 11, 17, 19, 20, 25, 29, 30, 32, 33, 36, 38, 39 The type of surgical treatment selected was dependent on the size and location of the stones. 5 studies reported various stone positions from unilateral, bilateral, left and right kidney, calyceal, pelvic and ureteral cystine stones.…”

Section: Resultsmentioning

confidence: 99%

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Intervention strategies for cystinuria: A systematic review

Bhatt

Deshpande

Jones‐Freeman

et al. 2020

Preprint

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Purpose: This systematic review evaluates the current intervention strategies for cystinuria and assesses their quality and efficacy in order to determine the need to identify new and improved strategies for treatment. Materials and Methods: A literature search for interventions in cystinuria was conducted on key electronic databases for studies published between 1996 and 2019. Quality was assessed using Methodological Index for Non-Randomized Studies (MINORS). Studies meeting the inclusion criteria were assessed for study design, patient characteristics and outcomes of interventions, including urinary cystine levels, stone-free rate and stone recurrence rate. A qualitative and critical analysis was performed. Results: Common treatment strategies for cystinuria include hydration and diuresis, alkali therapy and thiol-based therapeutics. Conservative therapies such as adequate hydration and urinary alkalization effectively increased urinary pH, decreased urinary cystine levels and the formation of cystine stones. Second line agents reported included thiols such as Tiopronin, D-penicillamine and captopril. Non-invasive surgical procedures were found to reduce operative trauma and preserved renal function. Combined treatment approaches with hydration and thiols after surgical procedures were associated with less stones and reduced stone recurrence rates. Patient compliance to interventions was often poor and contributed to recurrent cystine stones. Conclusions: Despite existing pharmacological intervention strategies, cystinuria patients frequently require surgical procedures. A more detailed understanding of the mechanisms of pathogenesis of cystinuria as well as an evaluation of patients on an individual basis may be beneficial in reducing the severity of cystinuria, by reducing stone recurrence and associated renal complications.

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“…Based on the severity of the disease, obstructive syndromes, recurrent urinary tract infections (UTIs), and even organ damage can occur. With the persistence of these symptoms, chronic pain is also a common complaint in patients with cystinuria [ 2 , 4 , 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%