A 40-year-old male with a history of cystinuria presents with recurrent kidney stones despite adequate fluid intake and dietary modification. What would be the next step in management?
Cystinuria is a condition characterized by defective renal reabsorption of cystine, leading to the formation of cystine stones, which can be difficult to manage with hydration and dietary changes alone. When these conservative measures are insufficient, medication is usually the next step. Options include cystine-binding thiol drugs, such as D-penicillamine and tiopronin, which can help dissolve the cystine stones and prevent new ones from forming.