{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T23:17:23Z","timestamp":1787008643936,"version":"build-2736575974"},"reference-count":19,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T00:00:00Z","timestamp":1761696000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,11,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Cystinuria is a rare autosomal recessive disorder characterized by impaired renal reabsorption of cystine and dibasic amino acids, leading to recurrent nephrolithiasis. While dietary salt and protein restriction are commonly recommended, evidence supporting their effectiveness in reducing urinary cystine excretion is limited. This study investigated whether intra-individual changes in dietary salt and protein intake are associated with changes in cystine excretion over time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study of 41 adult patients with recurrent cystine stones treated at a tertiary kidney stone clinic between 2004 and 2023. All patients underwent five 24-hour urine collections at intervals of 6\u201312 months. Urinary sodium and urea excretions were used as surrogates for salt and protein intake, respectively. Mixed-effects linear regression models assessed within-person associations between dietary intake and urinary cystine excretion, adjusting for age, sex, and time.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Cystine excretion showed considerable intra-individual variability (intraclass correlation coefficient: 0.457). An increase in urinary urea of 3.5\u00a0g\/24\u00a0h (reflecting \u223c10\u00a0g\/day higher protein intake) was associated with a 164\u00a0\u00b5mol\/24\u00a0h increase in cystine excretion (95% CI: 57 to 271, P\u00a0=\u00a0.003). In contrast, a 17\u00a0mmol\/24\u00a0h increase in urinary sodium (\u223c1\u00a0g\/day salt intake) was associated with a non-significant 46\u00a0\u00b5mol\/24\u00a0h increase in cystine excretion (95% CI: \u22125 to 97, P\u00a0=\u00a0.081).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Protein intake is moderately associated with urinary cystine excretion, whereas salt intake has minimal effect. These findings suggest that, while protein moderation may contribute to cystine reduction, fluid intake and urine alkalinization remain the primary determinants of urinary cystine levels.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ckj\/sfaf329","type":"journal-article","created":{"date-parts":[[2025,10,28]],"date-time":"2025-10-28T12:44:53Z","timestamp":1761655493000},"source":"Crossref","is-referenced-by-count":1,"title":["Dietary salt and protein intake and urinary cystine excretion in patients with cystinuria"],"prefix":"10.1093","volume":"18","author":[{"given":"Francesca","family":"Bermond","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Unit , Medical Department, A.O. Ordine Mauriziano di Torino, Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Fabbrini","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit , Medical Department, A.O. Ordine Mauriziano di Torino, Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Rivoli","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit , Medical Department, A.O. Ordine Mauriziano di Torino, Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6044-7256","authenticated-orcid":false,"given":"Andrea","family":"Spasiano","sequence":"additional","affiliation":[{"name":"Section of Nephrology , Department of Medicine, Universit\u00e0 degli Studi di Verona; Nephrology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Leporati","sequence":"additional","affiliation":[{"name":"Kidney Stone Laboratory, A.O. Ordine Mauriziano di Torino , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Petrarulo","sequence":"additional","affiliation":[{"name":"Kidney Stone Laboratory, A.O. Ordine Mauriziano di Torino , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Ricotti","sequence":"additional","affiliation":[{"name":"Clinical Trial Unit, A.O. Ordine Mauriziano di Torino , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucia","family":"Borsotti","sequence":"additional","affiliation":[{"name":"Clinical Trial Unit, A.O. Ordine Mauriziano di Torino , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martino","family":"Marangella","sequence":"additional","affiliation":[{"name":"Fondazione Scientifica Mauriziana O.N.L.U.S. , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Domenico","family":"Cosseddu","sequence":"additional","affiliation":[{"name":"Kidney Stone Laboratory, A.O. Ordine Mauriziano di Torino , Turin ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1379-022X","authenticated-orcid":false,"given":"Pietro Manuel","family":"Ferraro","sequence":"additional","affiliation":[{"name":"Section of Nephrology , Department of Medicine, Universit\u00e0 degli Studi di Verona; Nephrology Unit, Azienda Ospedaliera Universitaria Integrata Verona, Verona ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Corrado","family":"Vitale","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit , Medical Department, A.O. 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