Effect of urinary macromolecules and chondroitin sulphate on calcium oxalate crystallization in urine.

After filtration and ultrafiltration (10 kD) of 24 hour urine specimens from 12 healthy male subjects, calcium oxalate crystallization was induced in the filtered (FILTD) and ultrafiltered (UF) fractions by administration of a sodium oxalate load. In addition crystallization was also induced in UF fractions to which physiological quantities of chondroitin sulphate (CHON) had been added (UF+CHON). The rate of calcium oxalate crystallization was determined by measuring the rate at which turbidity increased. Crystal numbers and sizes were measured with a Malvern particle size analyzer and by scanning electron microscopy. Crystallization rates, crystal numbers and crystal sizes were generally lower in UF fractions than in FILTD fractions suggesting that urinary macromolecules are promoters of calcium oxalate crystallization. No increase in crystallization rate, crystal numbers or sizes occurred when chondroitin sulphate was added to UF fractions, indicating that the promoter activity of urinary macromolecules is not due to this particular glycosaminoglycan. On the contrary, crystallization rates were qualitatively lower in UF+CHON fractions than in UF fractions alone, suggesting a possible inhibitory role for chondroitin sulphate in real urine. Scanning electron microscopy revealed that while aggregates were present in UF and FILTD fractions, they were absent in UF+CHON fractions. This observation indicates that chondroitin sulphate might be an inhibitor of calcium oxalate crystal aggregation in real urine.