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Case-based review of dietary management of cystinuria

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Abstract

Purpose

The currently recommended treatment strategy for cystine stone formers is based on a progressive approach that starts with the most conservative measures. In patients with cystinuria, increased patient compliance with dietary management and medical treatment is associated with fewer stone interventions. In this case-based review, the dietary management of cystine stone former was reviewed under the guidance of evidence-based medicine.

Methods

The dietary management of the 13-year-old cystinuria patient, who underwent 18 endourological stone interventions, was reviewed in the light of evidence-based medicine. A literature search was performed in Pubmed, MEDLINE, Embase, and Cochrane Library databases according to PRISMA guidelines published from 1993 to September 2022. A total of 304 articles were included in this paper.

Results

In managing patients with cystinuria, hyperhydration, and alkalinization of the urine with medical treatment, the rational use of cystine-binding drugs by taking into account individual situations has come to the fore. A limited study has argued that a vegetarian diet is effective as the alkaline load from fruits and vegetables can reduce the amount of alkalizing substances required to achieve urinary alkalinization above pH 7.5, making it particularly suitable for the dietary treatment of cystine stone disease.

Conclusion

Life-long follow-up with dietary modification, hyperhydration, and personalized medical therapy (alkalinization and cystine-binding drugs) are critical in preventing chronic kidney disease and kidney failure in cystinuria.

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Data availability

No data was used for the research described in the article.

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Authors and Affiliations

  1. Department of Urology, Meram School of Medicine, Necmettin Erbakan University, Konya, Turkey

    Harun Ucmak, Mehmet Giray Sonmez & Selcuk Guven

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  1. Harun Ucmak
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  2. Mehmet Giray Sonmez
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  3. Selcuk Guven
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Contributions

HU: literature search, project development, data collection, analysis and interpretation, manuscript writing/editing; MGS: analysis and interpretation, manuscript writing/editing; SG: critical revision, project development, data collection, analysis and interpretation, manuscript writing/editing.

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Correspondence to Selcuk Guven.

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Ucmak, H., Sonmez, M.G. & Guven, S. Case-based review of dietary management of cystinuria. World J Urol 41, 1215–1220 (2023). https://doi.org/10.1007/s00345-022-04263-1

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  • DOI: https://doi.org/10.1007/s00345-022-04263-1

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