Mathematic and statistic of cystine stones

Abstract EN

A 23 pediatric patients (between neonate and 18 years old) had renal stones diagnosed to be cystine stone and diagnoses either by stone analysis or 24 hour urine biochemistry and three principles of treating those patients starting from dietary, excess fluid, alkalinization of urine, surgery and / or ESWL finishing by D-penicillamine) ; all had been applied in our patients ; it was seen that the presence of mixed calculi was the most common reason for failure of therapy with alkalanization of urine but not with Dpenicillamine ; increased oral fluid and alkalinazation of the urine to dissolve existing stone.

In our patients 5 cases respond to alkaline only, no need to penicillamine only 1 case had mixed stone containing calcium phosphate which was recurrent, other 2 cases cystine only, other 1 with uric acid, the last one with oxalate only.

All our patients show response to D-penicillamine and the recurrence rate show no difference between cystine only and those with calcium oxalate and / or phosphate.

So the stone with mixed type especially with calcium phosphate alter the response to alkali but not affect the response to D-penicillamine., very few side effects reported from D-penicillamine use so such report advised to be done in larger number of patients and every patient with renal stone need to be determined the type of stone to be managed accordingly and as early as possible to prevent the complication of such stone.