Cystinuria: description of a simple method of determination and our 5-year clinical experience

Ion exchange chromatography is the best method for the determination of cysteine in urine, but it requires an expensive apparatus, specialized technicians and a long time. The major colorimetric procedure is the nitroprusside color reaction first described by Brand, but it involves the reaction with toxic cyanide reagent. Moreover commercial stick are not available. We have experienced a colorimetric procedure in which the sulfhydryl group of cystine reduces phosphotungstic acid to tungstic blue, which is determined photometrically. This procedure avoids the use of cyanide. We used this screening test during 5 years of ambulatory evaluation of nephrolithiasis and we found these results: urine cystine 191 controls: 87 +/- 57 mg/day, 870 stone oxalate and uric acid patients: 99 +/- 57 mg/day, 11 stone cystine patients: 479 +/- 379 mg/day (p 0.001). A close correlation was found in stone cystine patients between our data obtained in the same sample with ion exchange chromatography. We conclude that this inexpensive and simple method can be recommended as a screening test for cystinuria.