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Titolo:
MEDICAL-TREATMENT OF CYSTINURIA - RESULTS OF CONTEMPORARY CLINICAL-PRACTICE
Autore:
CHOW GK; STREEM SB;
Indirizzi:
CLEVELAND CLIN FDN,DEPT UROL,DESK A100,9500 EUCLID AVE CLEVELAND OH 44195 CLEVELAND CLIN FDN,DEPT UROL CLEVELAND OH 44195
Titolo Testata:
The Journal of urology
fascicolo: 5, volume: 156, anno: 1996,
pagine: 1576 - 1578
SICI:
0022-5347(1996)156:5<1576:MOC-RO>2.0.ZU;2-G
Fonte:
ISI
Lingua:
ENG
Soggetto:
URINARY CYSTINE; CAPTOPRIL; RESTRICTION; MANAGEMENT; EXCRETION; SODIUM;
Keywords:
CYSTINURIA, URINARY CALCULI;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
12
Recensione:
Indirizzi per estratti:
Citazione:
G.K. Chow e S.B. Streem, "MEDICAL-TREATMENT OF CYSTINURIA - RESULTS OF CONTEMPORARY CLINICAL-PRACTICE", The Journal of urology, 156(5), 1996, pp. 1576-1578

Abstract

Purpose: We determined the efficacy of a contemporary medical regimenfor treatment of cystinuria. Materials and Methods: A total of 16 patients with cystinuria was followed for 7 to 141 months (mean 78.1). Standard therapy included hydration and alkalization. D-penicillamine oralpha-mercaptoproprionylglycine was added for failure of hydration and alkalization to prevent new stones or stone growth, or to cause dissolution. Captopril was added for failure of or intolerance to D-penicillamine or alpha-mercaptopropionylglycine. Radiography was performed every 6 to 12 months, at which time stone events were documented. Results: During hydration and alkalization 46 stone events occurred in 8 of9 patients (1.6 events per patient-year). With addition of thiol derivatives 7 of 9 patients experienced 24 stone events, all 6 treated with hydration, alkalization and captopril experienced 10 events, and 4 of 5 treated with alkalization, thiols and captopril experienced 8 events (0.52, 0.71 and 0.54 events per patient-year, respectively). Duringa total treatment time of 104.1 patient-years 88 stone events occurred in 14 of 16 patients (0.84 events per patient-year). Conclusions: D-penicillamine and alpha-mercaptopropionylglycine are effective in decreasing the rate of stone formation in patients in whom hydration and alkalization failed. While captopril may also be beneficial in this setting, it does not appear to be as effective as D-penicillamine or alpha-mercaptopropionylglycine, and it does not clearly add clinical benefit to those thiols. Our study demonstrates that patients with cystinuria are at high risk for recurrence when treated with any contemporary medical program. This natural history must be considered when evaluating the long-term efficacy of newer or alternative modes of medical andurological treatment.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 24/11/20 alle ore 13:18:55