Composition and inhibitory properties of endogenous urinary GAGS are different in subjects from two race groups with different occurrence rates of kidney stones: Pilot studies provide unique evidence in support of an inhibitory role for this group of compounds.

BACKGROUND: Calcium oxalate (CaOx) kidney stone disease is common in South African whites (W) but is rare in the black population (B). The possible role of endogenous urinary glycosaminoglycans (GAGs) has not been previously investigated in this context. AIM: To determine concentration, composition, structure and CaOx crystal-inhibiting properties of this group of compounds in ultrafiltered urine of healthy subjects from both groups. MATERIALS AND METHODS: GAGS were isolated from 24 h urine samples and were quantified and characterized by sequential precipitation, Bradford protein assay, high performance liquid chromatography, and anion exchange high performance chromatography. CaOx crystal inhibition was determined in ultrafiltered urinary fractions to which purified GAGS (PG) from each group (PGB and PGW) had been added. Nucleation, growth and aggregation were measured by Coulter particle counting, spectrophotometric assay and [14C]-oxalate deposition. RESULTS: Higher concentrations of chondroitin sulfate (CS) were found in PGB than in PGW. PGB inhibited crystallization to a greater extent than PGW. CONCLUSIONS: We attribute the stronger inhibitory effect of PGB to its higher content of CS and suggest that the superior inhibition of CaOx crystallization by PGB relative to PGW might be a contributory factor in accounting for the lower stone occurrence rate in B.

Seeking consistency for the role of urinary macromolecules and glycosaminoglycans in calcium oxalate crystallization processes pertaining to the risk of renal stone formation using a multi-faceted basic science approach.

BACKGROUND: The roles of urinary macromolecules (UMMs) in calcium oxalate (CaOx) renal stone formation have not been consistently established. AIM: To unravel these roles using a multi-faceted, multi-technique approach employing a wide range of experimental variables on a rotational basis in strategically chosen combinations. METHODS: Endogenous urinary glycosaminoglycans (GAGs) were investigated in fractions obtained after ultrafiltration of pooled human urine (HU). Exogenous GAGs (chondroitin sulphate, CS, and hyaluronic acid, HA) were studied in artificial (AU) and in individual HUs. Experiments were conducted in a batch crystallizer and in a mixed suspension, mixed product removal flow system. Crystallization was quantitatively followed using Coulter multisizer and flow cytometer techniques. Crystal aggregation in the presence and absence of exogenous CS and HA was measured by Zeta potential and crystal sedimentation. RESULTS: Total UMMs (endogenous) and individual GAGs (exogenous) consistently promoted CaOx crystallization and disaggregation. Evidence of UMM-UMM and UMM-solution synergistic effects was consistently observed for achieving modulation of crystallization processes. CONCLUSIONS: Total UMMs, the main modulatory component of which is GAGs, are promoters of CaOx crystal nucleation and inhibitors of CaOx crystal aggregation. These results allow researchers to disregard alternative roles that have been advocated in such studies.