**7. Treatment of cystinuria**

Cystinuria is an inherited metabolic disorder requiring lifelong treatment. In the absence of any specific treatment to reverse the abnormal dibasic amino acid transport, the target of therapy is to prevent cystine stone formation and thereby minimise complications of recurrent nephrolithiasis. Management of patients should ideally be undertaken in dedicated metabolic stone clinics [14]. Initial treatment is focussed on increased fluid intake, dietary modification and urinary alkalisation, but these interventions are cumbersome and patient compliance often limits their effectiveness. In refractory cases, a cystine-binding drug may be added to the treatment regime, although continued adherence to the initial conservative treatments is crucial for successful outcomes. Surgical intervention is reserved for large or symptomatic calculi which are causing obstruction, infection or pain.
