Stopping the Stones

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Science  15 Oct 2010:
Vol. 330, Issue 6002, pp. 325-326
DOI: 10.1126/science.1197207

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An imbalance in the fluid and mineral content of urine can cause debilitating kidney stones to form. Most of the time, the stones are composed of calcium oxalate crystals. Much less common are stones that develop from crystals of the amino acid l-cystine. The latter only occurs in patients with cystinuria, a condition with great morbidity due to the early age of onset, high frequency of stone recurrence, and increased risk of chronic kidney damage (1). The rarity of the disease—it occurs in about 1 in 15,000 in the United States—has deprived the field of clinical trials to assess treatment options. Treatment has not changed in over 20 years and remains unsatisfactory for many patients. On page 337 in this issue, Rimer et al. (2) report a potential new therapy for cystinuria, using compounds to retard cystine crystal growth.