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A random Abstract
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New horizons in the management of patients with cystinuria.
[cystinuria]
Although
the
formation
of
cystine
stones
is
seen
in
only
a
small
fraction
of
all
patients
with
urolithiasis
,
this
disease
is
associated
with
a
pronounced
morbidity
.
The
difficult
clinical
management
of
these
patients
,
with
the
aim
of
arresting
or
decreasing
the
rate
of
recurrent
stone
formation
,
is
well
recognized
.
This
review
summarizes
some
recent
knowledge
.
An
early
and
correct
diagnosis
of
cystinuria
is
fundamental
for
a
successful
course
of
the
disease
in
these
patients
.
Formation
starts
early
in
life
,
and
attention
to
this
diagnosis
is
necessary
for
the
paediatric
stone
formers
.
New
radiological
and
biochemical
improvements
seem
useful
in
this
respect
.
A
combination
of
medical
tools
is
usually
necessary
to
influence
the
very
often
,
troublesome
stone-forming
activity
.
Urine
dilution
,
alkalization
and
chelating
therapy
have
remained
the
cornerstones
of
the
therapeutic
approach
.
The
importance
of
a
high
urine
pH
has
been
further
emphasized
,
and
the
possibility
to
use
acetazolamide
is
a
promising
improvement
of
the
medical
treatment
.
In
order
to
increase
the
compliance
and
reduce
the
need
of
active
stone
removal
,
special
stone
clinics
seem
to
be
of
particular
value
.
The
understanding
of
the
genetic
background
might
open
future
treatment
alternatives
.
Patients
afflicted
by
cystine
stone
disease
need
an
aggressive
medical
treatment
,
gentle
stone-removing
surgery
and
careful
follow-up
.
