title: Clinical effect of captopril on the formation and growth of cystine calculi.
abstract: We determined the clinical efficacy of captopril for the prevention of new or stone growth in patients with homozygous cystinuria. Nine patients with a history of multiple cystine stones despite standard fluid and alkalization therapy received 50 mg. captopril, 3 times daily in addition to the standard therapy. Before treatment the rate of new stone formation or stone growth ranged from 0.7 to 2.0 events (mean 1.2) per patient-year for 1 to 3 years of observation (mean 1.9). During treatment the rate ranged from 0 to 3.0 events (mean 1.03) per patient-year for 0.5 to 6 years (mean 2.9). Although statistical significance was not evident for the group as a whole (p = 0.35), our findings suggest that captopril may be clinically efficacious in at least some patients with difficult to control cystinuria. Recommendations regarding its indications in this setting are made.
authors.affiliation: Department of Urology, Cleveland Clinic Foundation, Ohio 44195, USA.
authors.forename: T D
authors.initials: TD
authors.lastname: Cohen
authors.forename: S B
authors.initials: SB
authors.lastname: Streem
authors.forename: P
authors.initials: P
authors.lastname: Hall
mesh_terms: D000328:Adult; D000368:Aged; D002216:Captopril / Q000627:therapeutic use*; D002951:Citrates / Q000627:therapeutic use; D019343:Citric Acid; D003553:Cystine / Q000032:analysis; D003555:Cystinuria / Q000150:complications / Q000188:drug therapy* / Q000652:urine; D005260:Female; D005440:Fluid Therapy; D005500:Follow-Up Studies; D006801:Humans; D007669:Kidney Calculi / Q000737:chemistry / Q000209:etiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D002951:Citrates; D019343:Citric Acid; D003553:Cystine; D017693:Sodium Bicarbonate; D002216:Captopril