Extracorporeal shock wave lithotripsy and glycosaminoglycans in urine

In 50 calcium oxalate stone-forming patients, the total excretion of glycosaminoglycans (GAGs) and of four of its subgroups [chondroitin-4-sulfate (CS-A), chondroitin-6-sulfate (CS-C), dermatan sulfate (DS), and hyaluronic acid (HY)] were investigated before ESWL and on the following 5 days. The standard value was determined by reference to a group of healthy test subjects. The excretion of GAGs was significantly higher in healthy test persons than in stone-forming patients. Twenty-four hours after ESWL, GAG excretion increased significantly but returned to normal values in the course of three days. ESWL had no influence on the proportional composition of GAG subgroups CS-A, CS-C, DS and HY. The increase in GAG excretion after ESWL indicates a transient injury of renal tissue and of the mucous layer lining the urothelium, respectively. This lesion, however, can be regarded as temporary with restitutio ad integrum later.