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Regulation by macromolecules of calcium oxalate crystal aggregation in stone formers

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Abstract

Based on the structure of kidney stones, it is likely that they form as aggregations of preformed crystals, mostly calcium oxalate monohydrate (COM). In this study, we examined the ability of a macromolecular mixture isolated from the urine of normal individuals and stone formers to inhibit aggregation of preformed COM seed crystals in a simple ionic solution using measurements of changes in the particle size distribution (PSD) of preformed COM crystal aggregates. We also examined the effect in this assay of a number of synthetic homopolymers, naturally occurring urine macromolecules, and binary mixtures thereof. The macromolecular mixtures from urine of normals and most stone formers reduced the degree of aggregation of the seed crystals, whereas 22% of stone former urine macromolecules either did not disaggregate or actually promoted further aggregation. Stone formers within one family shared this property, but a non-stone forming sibling did not. Polyanions, either synthetic or naturally occurring, induced disaggregation to an extent similar to that exhibited by normal urine macromolecules, while polycations had no effect on the PSD. However, mixing a polyanion, either poly-aspartate or osteopontin, with the polycation poly-arginine, changed their behavior from disaggregation to aggregation promotion. The disaggregating behavior of normal urinary macromolecules provides a defense against aggregation, but a minority of stone forming individuals lacks this defense, which may contribute to stone formation.

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Acknowledgments

Supported by new investigator funds from Medical College of Wisconsin (J.A.W), a Career Development Award from the Department of Veterans Affairs (J.A.W.), and the N.I.H. (DK-48504; J.G.K.).

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Authors and Affiliations

  1. Department of Medicine/Nephrology, Veterans Affairs Medical Center and the Medical College of Wisconsin, 5000 W National Avenue (111 K), Milwaukee, WI 53295, USA

    J. A. Wesson, V. Ganne, A. M. Beshensky & J. G. Kleinman

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  1. J. A. Wesson
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  2. V. Ganne
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  3. A. M. Beshensky
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  4. J. G. Kleinman
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Correspondence to J. G. Kleinman.

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Wesson, J.A., Ganne, V., Beshensky, A.M. et al. Regulation by macromolecules of calcium oxalate crystal aggregation in stone formers. Urol Res 33, 206–212 (2005). https://doi.org/10.1007/s00240-004-0455-1

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  • DOI: https://doi.org/10.1007/s00240-004-0455-1

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