at normal urine pH and with typical urinary cystine excretion of 4 mmol per day, an adequate fluid intake would be more than 4 litres per day to keep urine cystine concentration less than 1 mmol per litre
urinary alkalinisation:
taking bicarbonates to keep urine pH above 8 at which cystine solubility is increased
D-penicillamine:
acts as a chelating agent but may need 1-2 g daily which may be poorly tolerated because of side effects
lysine supplementation:
this is the only essential aminoacid which is excessively excreted in cystinuria
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