{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,19]],"date-time":"2026-08-19T19:17:29Z","timestamp":1787167049250,"version":"build-2736575974"},"reference-count":47,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2019,3,25]],"date-time":"2019-03-25T00:00:00Z","timestamp":1553472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["bjui-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJU International"],"published-print":{"date-parts":[[2019,11]]},"abstract":"\n Objective<\/jats:title>\n To evaluate medical treatments, in terms of adverse events (AEs) and therapeutic goals, in a large series of patients with cystinuria.<\/jats:p>\n <\/jats:sec>\n \n Patients and Methods<\/jats:title>\n \n Data from 442 patients with cystinuria were recorded retrospectively. Crystalluria was studied in 89 patients. A mixed\u2010effects logistic regression model was used to estimate\u00a0how urine\n pH<\/jats:styled-content>\n , specific gravity and cysteine\u2010binding thiols (CBT) correlate with risk of cystine crystalluria.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Alkalizing agents and CBT agents were given to 88.8% (\n n<\/jats:italic>\n = 381) and 55.3% (\n n<\/jats:italic>\n = 238) of patients, respectively. Gastrointestinal AEs were reported in 12.3%, 10.4% and 2.6% of patients treated with potassium bicarbonate, potassium citrate and sodium bicarbonate, respectively (\n P<\/jats:italic>\n = 0.008). The percentages of patients who experienced at least one AE with tiopronin (24.6%) and with D\u2010penicillamine (29.5%) were similar (\n P<\/jats:italic>\n = 0.45). Increasing urine\n pH<\/jats:styled-content>\n and decreasing urine specific gravity significantly reduced the risk of cystine crystalluria, whereas D\u2010penicillamine and tiopronin treatments did not reduce this risk (odds ratio [\n OR<\/jats:styled-content>\n ] 1 for\n pH<\/jats:styled-content>\n \u22646.5;\n OR<\/jats:styled-content>\n 0.52 [95% confidence interval {95%\n CI<\/jats:styled-content>\n } 0.28\u20130.95] for 7.0 <\n pH<\/jats:styled-content>\n \u22647.5,\n P\u00a0<\/jats:italic>\n =\n \u00a0<\/jats:italic>\n 0.03;\n OR<\/jats:styled-content>\n 0.26 [95%\n CI<\/jats:styled-content>\n 0.13\u20130.53] for 7.5 <\n pH<\/jats:styled-content>\n \u22648.0,\n P<\/jats:italic>\n <0.001;\n OR<\/jats:styled-content>\n 1 for specific gravity \u22641.005\n OR<\/jats:styled-content>\n 5.76 [95%\n CI<\/jats:styled-content>\n 1.45\u201322.85] for 1.006 \u2264 specific gravity \u22641.010,\n P<\/jats:italic>\n = 0.01; and\n OR<\/jats:styled-content>\n 11.06 [95%\n CI<\/jats:styled-content>\n 2.76\u201344.26] for 1.011 \u2264 specific gravity \u2264 1.014,\n P<\/jats:italic>\n < 0.001). Increased urine\n pH<\/jats:styled-content>\n significantly increased the risk of calcium phosphate crystalluria (\n OR<\/jats:styled-content>\n 1 for\n pH<\/jats:styled-content>\n \u2264 6.5;\n OR<\/jats:styled-content>\n 6.09 [95%\n CI<\/jats:styled-content>\n 2.15\u201317.25] for\n pH<\/jats:styled-content>\n >8.0,\n P<\/jats:italic>\n <0.001).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n Adverse events were frequent with D\u2010penicillamine and tiopronin. Alkaline hyperdiuresis was well tolerated and reduced cystine crystalluria. Urine specific gravity \u22641.005 and urine\n pH<\/jats:styled-content>\n >7.5, while warning about calcium\u2010phosphate crystallization, should be the goals of medical therapy.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1111\/bju.14721","type":"journal-article","created":{"date-parts":[[2019,2,26]],"date-time":"2019-02-26T00:26:38Z","timestamp":1551140798000},"page":"849-861","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":45,"title":["Adverse events associated with currently used medical treatments for cystinuria and treatment goals: results from a series of 442 patients in France"],"prefix":"10.1111","volume":"124","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1373-1323","authenticated-orcid":false,"given":"Caroline","family":"Prot\u2010Bertoye","sequence":"first","affiliation":[{"name":"Department of Physiology, Functional Renal Explorations Department AP\u2010HP (Public Assistance Hospitals of Paris) Georges Pompidou European Hospital Paris Descartes University Paris France"},{"name":"INSERM UMRS 1138 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sa\u00efd","family":"Lebbah","sequence":"additional","affiliation":[{"name":"Department of Biostatistics AP\u2010HP Necker Hospital for Sick Children Paris Descartes University, Medicine Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Daudon","sequence":"additional","affiliation":[{"name":"Department of Physiology, Functional Renal Explorations Department AP\u2010HP Tenon Hospital Pierre and Marie Curie University INSERM UMR S 1155 Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabelle","family":"Tostivint","sequence":"additional","affiliation":[{"name":"Department of Nephrology AP\u2010HP Piti\u00e9\u2010Salp\u00e9tri\u00e8re Hospital Paris 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France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Cochat","sequence":"additional","affiliation":[{"name":"Department of Pediatrics Hospices Civils de Lyon Centre de R\u00e9f\u00e9rence des Maladies R\u00e9nales Rares N\u00e9phrogones Lyon France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Bataille","sequence":"additional","affiliation":[{"name":"Department of Nephrology Boulogne\u2010sur\u2010Mer Hospital Boulogne sur Mer France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Franck","family":"Bridoux","sequence":"additional","affiliation":[{"name":"Department of Neprhology Poitiers University Hospital Poitiers University Poitiers France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pierre","family":"Brignon","sequence":"additional","affiliation":[{"name":"Department of Nephrology Pasteur Hospital Colmar 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