A Case Report of Cystinuria with Anuria as the First Symptom and Literature Review

Abstract

Patients with urinary stones typically present to the doctor with hematuria, low back pain, and abdominal pain. This paper reports a case of cystinuria with anuria as the first symptom. The patient’s initial blood test showed creatinine of 2028.70μmol/L and uric acid of 1072.65μmol/L, and a CT scan showed both kidneys and ureters full of stones. The patient underwent hemodialysis, bilateral renal puncture fistulas, and multiple PCNL and flexible ureteroscopic laser lithotripsy to crush stones. Post-operative review creatinine of 138.08μmol/L, uric acid of 230.00μmol/L, and a CT scan showed clearance of the stones, and compositional analysis of the stones showed that they consisted exclusively of cystine. After undergoing postoperative hydration, urinary alkalinization, and an animal protein intake restriction, the patient’s condition became better and there has been no recurrence of the stones. Patients with this kind of disease should be identified, diagnosed, and prevented at an early stage in order to reduce the number of surgeries and preserve renal function. Cystinuria
is prone to recurrence, which can lead to urinary tract obstruction and urinary tract infection, which raises the risk of acute and chronic renal disease.