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Title
Cystinuria
ImagePath
System
Renal amino‑acid transport defect
Overview
AR defect of PCT & intestinal AA transporter for COLA (Cys, Orn, Lys, Arg) → ↓ reabsorption → cystine kidney stones.
Pathophysiology
Poorly soluble cystine forms hexagonal crystals in urine and staghorn calculi.
Presentation
Recurrent flank pain, hematuria, urinary hexagonal crystals, nephrolithiasis in teens/20s.
Diagnosis
Cyanide‑nitroprusside urine test +; stone analysis; genetic testing.
Management
High‑fluid intake, urinary alkalinization (potassium citrate, acetazolamide), chelation with penicillamine, low‑methionine diet.
Epidemiology
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