Alpha Lipoic Acid

Hey, this is Kyle Wood

with the Kidney Stone Collaborative.

I’m an associate professor at the University of Alabama

and specialize in kidney stones.

Today I kind of wanted to talk about cystinuria in the role

of alpha lipoic acid.

As many of you know, the, uh,

cystinuria is a rare genetic condition

that causes kidney stones, causes cystine stones,

which are different from the calcium

stones that most people form.

When it comes to cystinuria,

they have highly recurrent stone disease

and, uh, medications are limited in our treatment.

We do still focus on increasing fluids,

decreasing salt intake

as decreased salt shows decreased cystine in the urine

and less likely to form cystine stones.

And then there are some medications.

We come in with alkalizing agents such as potassium citrate.

And then there are medications like Thiola that are drugs

that bind to the cysteine, making them more soluble for

so less likely to form kidney stones.

So this brings up alpha lipoic acid.

Early preclinical work in mouse models of cystinuria showed

that alpha lipoic acid could help with reduction of, uh,

risk factors in stones in cystinuria in mice.

So this has gone into clinical trials now

with primary investigators being Dr.

Chi and Dr. Stoller out California.

And, uh, some of the data

that’s been presented at the American Urological Association

shows that they have decreased stone burden

and, uh, stone risk like, uh, events, stone events

with the use of alpha lipoic acid.

The nice thing about alpha lipoic acid is it’s a supplement.

It is taken by a number of individuals, does not appear

to have any consequences when taken appropriately.

And so as a treatment modality

for cystinuria, it makes a lot of sense.

I do give it to my patients

that have cystinuria given the data that we have seen so far,

again, it’s been shown to decrease stone burden.

Interestingly, when you look at the urinary parameters,

it has no effect on the urinary parameters.

So, for example, it does not decrease like cysteine levels,

so the mechanism of action is still unknown.

And so with all of that together, I do recommend

that my patients take al alpha lipoic acid.

Again, with any treatment, you need to talk

to your urologist and your physician,

and this should be catered to your individual needs.

So if you are a cystinuria patient,

you should bring this up with your nephrologist or urologist

or anybody that’s dealing with your stones

and discuss the risks and benefits.

Hope that helps and take care.