Urinary sulfated glycosaminoglycan insufficiency and chondroitin sulfate supplement in urolithiasis

Abstract

Familial members of urolithiasis have high risk for stone development. We observed the low sulfated glycosaminoglycan (GAG) excretion in urolithiasis patients and their descendants. In this study, we investigated urinary excretion of sulfated GAG, chondroitin sulfate (CS), heparan sulfate (HS) and hyaluronic acid (HA) in urolithiasis and their children, and explored the effect of CS and HA supplement in urolithic hyperoxaluric rats. The 24-hour urines were collected from urolithiasis patients (28) and their children (40), as well as healthy controls (45) and their children (33) to measure urinary sulfated GAG, CS, HS and HA excretion rate. Our result showed that urinary sulfated GAG and CS were diminished in both urolithiasis patients and their children, while decreased HS and increased HA were observed only in urolithiasis patients. Percentage of HS per sulfated GAG increased in both urolithiasis patients and their children. In hyperoxaluric rats induced by ethylene glycol and vitamin D, we found that CS supplement could prevent stone formation, while HA supplement had no effect on stone formation. Our study revealed that decreased urinary GAG and CS excretion are common in familial members of urolithiasis patients, and CS supplement might be beneficial in calcium oxalate urolithiasis prophylaxis for hyperoxaluric patients.

Age-Specific Excretion of Calcium, Oxalate, Citrate, and Glycosaminoglycans and Their Ratios in Healthy Children and Children with Urolithiasis

“…This protective role of GAGs is consistent with observation for the lowest incidence of urinary stone formation in children 0–3 years [ 45 ]. Articles describing excretion of GAGs in urine are scarce and with no clear consensus [ 16 , 42 , 43 , 44 , 46 ]. Reduced excretion of GAGs’ in urine is rarely reported in children [ 15 , 42 , 44 , 46 ].…”

Antiurolithiatic effects of pentacyclic triterpenes: The distance traveled from therapeutic aspects

“…GAGs hinder the adhesion of calcium oxalate (CaOx) crystals to the renal wall. The logical extension of these observations is that in conditions of GAG storage disorders, CaOx promotes urolithiasis (Dissayabutra et al, 2019;Verkoelen, 2006). CaOx stones increase to few centimeters in size, and when detached from the papillary tip, they often block urinary flow (Wesson & Ward, 2007).…”

Urine and serum glycosaminoglycan levels in the diagnosis of urological diseases and conditions: A narrative review of the literature

“…42 Although various inhibitory effects of GAGs on stone formation were identified in several in vitro studies, the results of studies comparing urinary GAG levels in patients and control groups are contradictory. 13,35,39,[43][44][45] Many reports showed low urinary GAGs in adult nephrolithiasis patients. 38,39,43,[45][46][47][48] Ombra et al 48 separated the patients into subgroups and found a significant difference in the urinary GAG/creatinine ratio between the recurrent stone disease patients and the first-time stone disease patients.…”

“…13,35,39,[43][44][45] Many reports showed low urinary GAGs in adult nephrolithiasis patients. 38,39,43,[45][46][47][48] Ombra et al 48 separated the patients into subgroups and found a significant difference in the urinary GAG/creatinine ratio between the recurrent stone disease patients and the first-time stone disease patients. Dissayabutra et al revealed that urinary decrease in GAG and CS excretion and an increase in HS excretion are common in patients with urolithiasis and their family member.…”

“…Dissayabutra et al revealed that urinary decrease in GAG and CS excretion and an increase in HS excretion are common in patients with urolithiasis and their family member. 45 Kidney stones are rare in children. The results of the total GAG excretion in children with different ethnicities and diet compositions are contradictory.…”