The possible litholytic effect of Ononis Spinosa L. on various human kidney stones—An in vitro experimental evaluation

Efficacy and Safety of Boldine Combined with Phyllanthus niruri and Ononis spinosa in Medical Expulsive Therapy for Distal Ureteral Stones with Renal Colic: A Single-Center, Retrospective Cohort Study

Background and Objectives: This study aimed to compare the effects and safety of boldine combined with Phyllanthus niruri and Ononis spinosa plus tamsulosin vs. tamsulosin alone in medical expulsive therapy (MET) for distal ureteral calculi. Materials and Methods: This retrospective cohort study was conducted on 159 renal colic patients with distal ureteric stones (≤10 mm). Patients aged between 18 and 70 years or older with distal ureteral (below the sacroiliac joint) stones ≤10 mm (defined by the largest diameter in three planes) confirmed by urinary ultrasonography and/or native computed tomography (CT). Patients were divided into two groups: A and B. Patients in Group A received tamsulosin 0.4 mg plus boldine combined with Phyllanthus niruri and Ononis spinosa, while those in Group B received tamsulosin 0.4 mg. The rate of stone expulsion, duration of stone expulsion, the dose and the duration of nonsteroidal anti-inflammatory drugs (NSAIDs), analgesic use, and adverse effects of drugs were recorded. Results: No differences were reported in demographic profiles between the two groups. The stone expulsion rate in Group A (84.8%) was higher in comparison to Group B (52.5%); the mean time of stone expulsion was 16.33 ± 4.75 days in Group A and 19.33 ± 6.42 days in Group B. The mean requirement time of analgesia was significantly less in Group A, 2.42 ± 2.56, than in Group B, 6.25 ± 3.05. Drug-related adverse effects (headache, dizziness, nausea, vomiting, postural hypotension, backache, and running nose) were comparable between the two groups. Conclusions: Tamsulosin plus boldine combined with Phyllanthus niruri and Ononis spinosa as medical expulsion therapy is more effective for distal ureteric stones with less need for analgesics and a shorter stone expulsion time than tamsulosin alone.

Plant-based therapies for urolithiasis: a systematic review of clinical and preclinical studies

PURPOSE

Urolithiasis, the formation of kidney stones, is a common and severe condition. Despite advances in understanding its pathophysiology, affordable treatment options are needed worldwide. Hence, the interest is in herbal medicines as alternative or supplementary therapy for urinary stone disease. This review explores the use of plant extracts and phytochemicals in preventing and treating urolithiasis.

METHODS

Following PRISMA standards, we systematically reviewed the literature on PubMed/Medline, focusing on herbal items evaluated in in vivo models, in vitro studies, and clinical trials related to nephrolithiasis/urolithiasis. We searched English language publications from January 2021 to December 2023. Studies assessing plant extracts and phytochemicals' therapeutic potential in urolithiasis were included. Data extracted included study design, stone type, plant type, part of plant used, solvent type, main findings, and study references.

RESULTS

A total of 64 studies were included. Most studies used ethylene glycol to induce hyperoxaluria and nephrolithiasis in rat models. Various extraction methods were used to extract bioactive compounds from different plant parts. Several plants and phytochemicals, including Alhagi maurorum, Aerva lanata, Dolichos biflorus, Cucumis melo, and quercetin, demonstrated potential effectiveness in reducing stone formation, size, and number.

CONCLUSIONS

Natural substances offer an alternative or supplementary approach to current treatments, potentially reducing pain and improving the quality of life for urolithiasis patients. However, further research is needed to clarify their mechanisms of action and optimize their therapeutic use. The potential of plant-based therapies in treating urolithiasis is promising, and ongoing research is expected to lead to treatment advancements benefiting patients globally.

Synthesize and characterization of CaOx crystals against various citrus waste peel extracts: an in vitro study

Citrus fruits have been consumed by world's population for several centuries. Since it's an edible source possesses various uses in treating many diseases. Among various diseases urolithiasis is one of the major issues globally demands in painless surgical treatment. Calcium Oxalate (CaOx) is found to be the most prevailing constituent of renal calculus in humans which tends to be the categories of the urolithiasis. Citric acid is commonly used in treating to dissolve them in medications. Citrate compound has the ability to bind with calcium stones to relieve oxalates in urine. The objective of the present study is to assess the efficacy of citrate compounds from waste citrate peels describing the inhibition of calcium oxalate (CaOx) crystals. Multistep extraction procedures were performed for the selected citrus peels of Citrus limon, Citrus limetta and Citrus sinensis using different solvents (hexane, aqueous and ethanol) and were tested for its inhibitory actions with different parameters against the synthesized CaOx crystals. The synthetic CaOx crystals were characterized by Microscopy, FTIR, SEM, XRD, and TGA. The structural change in the crystal was observed for inhibition at various stages like nucleation, growth and aggregation when treated with the ethanol extracts of citrus peels. Thus the present investigation concludes that the ethanol extracts of C. sinensis peels highly inhibits at a concentration of 1000 (µg/mL) in 60 min when compared to other solvents. This research would give additional information in preparation of drugs against CaOx urolithiasis in future pharmaceutical development processes.