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The effect of prophylactic treatment with Shohl's solution in children with cystinuria.
[cystinuria]
To
investigate
the
effect
of
prophylactic
treatment
with
Shohl
's
solution
on
the
rates
of
stone
recurrence
in
paediatric
patients
with
cystinuria
.
Between
June
2007
and
October
2011
,
185
patients
aged
16
years
and
younger
whose
stones
had
been
completely
removed
by
percutaneous
nephrolithotomy
(
PCNL
)
were
assessed
for
metabolic
risk
factors
.
Seventeen
(
9
%
)
patients
with
positive
cyanide-nitroprusside
tests
(
CNT
)
and
cystine
stones
enrolled
in
this
study
,
and
a
Shohl
's
solution
was
used
for
alkalinisation
.
The
patients
were
followed
up
for
a
mean
period
of
two
years
for
stone
recurrence
.
Of
the
patients
,
10
(
59
%
)
were
male
,
and
7
(
41
%
)
were
female
(
p
Â
=
Â
0
.
13
)
.
Twelve
patients
(
70
.
5
%
)
continued
to
receive
medical
prophylaxis
regularly
,
whereas
5
(
29
.
5
%
)
patients
did
not
.
The
mean
pre-treatment
and
post-treatment
urinary
pH
values
were
5
.
8
Â
±
Â
0
.
5
(
5
-
7
)
and
7
.
5
Â
±
Â
0
.
4
(
6
.
5
-
8
)
,
respectively
(
p
Â
<
Â
0
.
001
)
.
The
pre-treatment
and
post-treatment
specific
gravities
of
the
urine
were
1021
.
5
Â
±
Â
5
.
4
(
1010
-
1030
)
and
1006
Â
±
Â
2
.
3
(
1004
-
1015
)
,
respectively
(
p
Â
<
Â
0
.
001
)
.
The
rates
of
recurrence
were
16
.
6
%
among
those
who
continued
prophylaxis
and
100
%
among
those
who
did
not
receive
prophylaxis
(
p
Â
=
Â
0
.
001
)
.
The
most
common
combination
of
metabolic
anomalies
was
cystinuria
and
hypocitraturia
(
p
Â
<
Â
0
.
001
)
.
This
study
demonstrated
that
detailed
clinical
and
laboratory
evaluations
should
be
performed
for
all
children
with
cystine
stone
disease
,
and
,
appropriate
prophylactic
treatment
should
be
recommended
to
prevent
the
reformation
of
stones
.
