Stone Disease

Question 1

What medication can be used to prevent struvite stones when surgical options have failed?
What are SEs of this medication?

Answer 1

Acetohydroxamic acid

SEs include: neurological, hematologists, teratogenic

Question 2

What type of stones have crystals shaped like hexagons?

Answer 2

Cystine

Question 3

What’s is pathophysiology of cystine stone formation?

Answer 3

Autosomal recessive inheritance
Can’t absorb COLA from the urine - cystine, ornithine, lysine, arginine.

Cystine bonds to another cystine to form disulfide bond. It’s insoluble and crystallizes.

Question 4

What’s the medical management of cystine stones?

Answer 4

1. Dietary - high fluid intake, avoid methionine-containing foods, low sodium
2. Urinary alkalization - Kcit or acetazolamide
3. If those don’t work, you try d-penicillamine or alpha-MCPG. Both have to be given with pyridoxine.