Potential nephroprotective phytochemicals: Mechanism and future prospects

ETHNOPHARMACOLOGICAL RELEVANCE

Kidney disease (KD) is one of the serious health issues, which causes worrisome morbidity and economic burden. Therapeutic strategies are available however majority of them are associated with severe adverse effects and poor patient compliance and adherence. This explorative article was undertaken to provide a holistic review of known nephroprotective (NP) phytoconstituents along with their research-based evidences on mechanism, sources, and clinical trials that may play essential role in prevention and cure of KD.

AIM OF THE STUDY

The present systematic review aimed to provide in-depth and better evidences of the global burden of KD, phytoconstituents as NP with emphasis on mechanism of action both in vitro and in vivo, their wide biological sources as well as their clinical efficacy in management of kidney disease and its related disorders.

MATERIAL AND METHODS

Comprehensive information was searched systematically from electronic databases, namely, PubMed, Sciencedirect, Wiley, Scopus, Google scholar and Springer until February 2021 to find relevant data for publication on phytoconstituents with nephroprotective potential.

RESULTS

In total, 24,327 articles were screened in first search for "phytoconstituents and medicinal plants for nephroprotection and kidney disorder". On the basis of exclusion and inclusion criteria, 24,091 were excluded. Only 236 papers were spotted to have superlative quality data, which is appropriate under titles and sub-titles of the present review. The phytoconstituents having multiple research evidence along with wide number of medicinal plants sources and mechanism reported for nephroprotection have been selected and reviewed.

CONCLUSION

This review, based on pre-clinical and clinical data of NP phytoconstituents, provides scientific-basis for the rational discovery, development and utilization of these upcoming treatment practices. Further,-more clinical studies are warranted to improve the pharmacodynamic and pharmacokinetic understanding of phytoconstituents. Also, more specific evaluation for natural sources is needed.

Effect of moonseed vine (Triclisia gilletii Staner) on ethane-1,2-diol-induced urolithiasis and its renotoxicity in Wistar albino rats

Background

Moonseed vine (Triclisia gilletii Staner) in the family Menispermaceae is a robust creeper of up to 10 cm diameter, of the lowland dense rain forest. In Ondo State, located in the South Western part of Nigeria, the plant which is usually called Peshe is used for the management of renal-related ailments. The present study was undertaken to explore the efficacy of Triclisia gilletii, a folkloric therapy in the management of renal-related ailment.

Results

Phenols, steroids, saponins, and flavonoids are present in the TGME with a total antioxidant capacity of (30.36 ± 1.90 (mg GAE/g extract), LD50 greater than 5000 mg/kg b.w., and in vitro anti-nucleation activity (iC50 = 7.09 mg/mL). Calcium oxalate stone formation as a result of oxalate from ethane-1,2-diol was evident by hypocalcemia, and further electrolyte imbalance and decreased glomerular filtration rate. The enhanced oxidative milieu in hyperoxaluria was evident by increased MDA and PC and decreased enzymatic and non-enzymatic antioxidants as well as renal membrane enzymes activities. The renal histopathological study further emphasized oxalate-induced damage and the ameliorative potential of TGME.

Conclusion

The abnormal biochemical, redox electrolyte, membrane integrity, and histological alterations were attenuated by TGME which affirms its usage as nephroprotectant.

Evaluation of anti-urolithiatic potential of ethyl acetate extract of Pedalium murex L. on struvite crystal (kidney stone)

Pedalium murex (L.) is a traditional herb, commonly used for the treatment of kidney stone related problems. Struvite stone can swiftly grow and become 'staghorn calculi' in kidney and its associated areas, which is the most aching urological disorder. The present study investigated the anti-urolithiasis activities of ethyl acetate extract of P. murex L. (EAEP) against struvite crystal. The antibacterial activity of EAEP examined against several urease producing bacteria. It showed the minimum bactericidal concentration (MBC) against Escherichia coli and Staphylococcus aureus (>125). On the other hand, total mass, volume, number, growth rate and dissolution rate of synthesised struvite crystals were observed at different concentrations 0.5%, 0.75%, 1% of EAEP and without EAEP. In which, EAEP addition showed appreciably reduced struvite crystal. Alternatively, MgO (300 mg of EAEP/kg/body weight) induced urolithiasis of Wistar albino rat at the rate of 1 ml for 28 days. Various biochemical parameters in serum, urine and histological analysis of kidney were taken for evaluation. Significant results (p < 0.05) were observed in 1% EAEP (300 mg) treated group than cystone treated group. From the histological study, reduced renal damage and glomerular development were observed. Our experiment, P. murex L. enhances the reducing activity on struvite crystal and prevents the crystal formation both in-vitro and in-vivo. It can be suggesting that P. murex L. and its phyto-components could be used as remedy for the management of kidney stone by dissolving the struvite stone in kidney.