A long-term study on the efficacy of a herbal plant, Orthosiphon grandiflorus, and sodium potassium citrate in renal calculi treatment.

Southeast Asian J Trop Med Public Health. 2001 Sep;32(3):654-60

Authors: Premgamone A, Sriboonlue P, Disatapornjaroen W, Maskasem S, Sinsupan N, Apinives C

The study was performed to compare the efficacy of a herbal plant, Orthosiphon grandiflorus (OG), and the drug sodium potassium citrate (SPC) in treatment of renal calculi. Forty-eight rural stone formers identified by ultrasonography were recruited and randomly assigned to two treatment groups (G1 and G2). For a period up to 18 months, subjects in G1 received 2 cups of OG tea daily, each tea cup made from an OG tea bag (contained 2.5 g dry wt), and G2 received 5-10 g of granular SPC in solution divided into three times a day. Once every 5 to 7 weeks, subjects were interviewed, given an additional drug supply, administered a kidney ultrasound and had spot urine samples collected for relevant biochemical analysis. From the recorded ultrasound images, rates of stone size reduction per year (ROSRPY) were calculated. The mean ROSRPY was 28.6+/-16.0% and 33.8+/-23.6% for G1 and G2, respectively. These two means were not significantly different. ROSRPY values of G1 and G2 were combined and divided into three levels: Level A (ROSRPY > mean + 0.5 SD), Level M (ROSRPY = mean +/- 0.5 SD) and Level B (ROSRPY < mean - 0.5 SD). Dissolution of stones was least in Level B which was related to higher excretions of Ca and uric acid in the urine. After treatment, 90% of the initial clinical symptoms (ie back pain, headaches and joint pain) were relieved. Fatigue and loss of appetite were observed in 26.3% of G2 subjects. Our study indicates that treatment of renal calculi with OG tea is an alternative means of management. Further investigation is needed to improve dissolution of stones with a low ROSRPY.

PMID: 11944733 [PubMed - indexed for MEDLINE]

Herbs and the kidney.

Am J Kidney Dis. 2004 Jul;44(1):1-11

Authors: Isnard Bagnis C, Deray G, Baumelou A, Le Quintrec M, Vanherweghem JL

The use of herbal therapy has increased dramatically in past years and may lead to renal injury or various toxic insults, especially in renal patients. In most countries, herbal products are not regulated as medicines. Herbal poisoning may be secondary to the presence of undisclosed drugs or heavy metals, interaction with the pharmacokinetic profile of concomitantly administered drugs, or association with a misidentified herbal species. Various renal syndromes were reported after the use of medicinal plants, including tubular necrosis, acute interstitial nephritis, Fanconi's syndrome, hypokalemia or hyperkalemia, hypertension, papillary necrosis, chronic interstitial nephritis, nephrolithiasis, urinary retention, and cancer of the urinary tract. It seems critical that caregivers be aware of the potential risk of such often underreported therapy and carefully question their patients about their use of this popular branch of alternative medicine.

PMID: 15211432 [PubMed - indexed for MEDLINE]

1,2,3,4,6-penta-O-galloyl-beta-D-glucose attenuates renal cell migration, hyaluronan expression, and crystal adhesion.

Eur J Pharmacol. 2009 Mar 15;606(1-3):32-7

Authors: Lee JH, Yehl M, Ahn KS, Kim SH, Lieske JC

Calcium oxalate monohydrate (COM) crystals bind avidly to the surface of proliferating and migrating renal endothelial cells, and oxalate-induced peroxidative injury can promote crystal attachment to renal epithelial cells. 1,2,3,4,6-penta-O-galloyl-beta-D-glucose (PGG), isolated from a traditional herbal remedy, inhibits vascular endothelial growth factor (VEGF) stimulated proliferation and migration of human umbilical vein endothelial cells (HUVECs) and has antioxidant activity. This study was performed to determine if PGG altered calcium oxalate monohydrate (COM) crystal adhesion to cells, perhaps via a change in cell surface properties. PGG significantly decreased COM crystal adhesion to cultured MDCK I cells at a low concentration (<10 microM) which was not cytotoxic. PGG exerted anti-adhesion effects whether cells or crystals were pre-coated. PGG also inhibited cell migration after scrape-wounding, decreased subsequent adhesion of crystals to proliferating and migrating cells, and decreased expression of the crystal binding molecule hyaluronan. These findings suggest that PGG represents a potential urolithiasis prevention compound. Anti-crystal adhesion effects appear multifaceted involving crystal coating by PGG, as well as decreased cell migration and the associated surface expression of hyaluronan. The latter represents a novel mechanism of nephrolithiasis prevention.

PMID: 19374853 [PubMed - indexed for MEDLINE]

Prophylaxis of experimentally induced calcium oxalate nephrolithiasis in rats by Zhulingtang, a traditional Chinese herbal formula.

Urol Int. 2009;82(4):464-71

Authors: Tsai CH, Pan TC, Lai MT, Lee SC, Chen ML, Jheng JR, Chen WC

BACKGROUND: Zhulingtang (ZLT), a traditional Chinese medicine formula, was used to evaluate the antilithic effects of experimentally induced calcium oxalate (CaOx) nephrolithiasis in ethylene glycol (EG)-fed rats. MATERIALS AND METHODS: A total of 35 male Sprague-Dawley rats were randomly divided into 4 groups. Rats in group 1 (n = 8) served as the normal control. Rats in group 2 (n = 11) were treated with gastric gavages of starch as placebo and 0.75% EG as a stone inducer. Rats in group 3 (n = 8) were given 0.75% EG and a low dose (305 mg/kg) of ZLT. Rats in group 4 (n = 8) were treated with EG and a high dose (915 mg/kg) of ZLT. Twenty-four-hour urine and blood samples were collected at the beginning and at the end of the experiment for biochemical analysis. The histological appearances of the kidneys were observed under a polarized light microscope, and the crystal deposits were evaluated by a semiquantitative scoring method, computer assisted with ImageScoring software. RESULTS: Our results revealed that rats fed with 0.75% EG for 4 weeks successfully produced renal deposition of CaOx. The severities of crystal deposition were significantly reduced in the 2 ZLT-fed groups compared with the placebo group (p = 0.025 and 0.047, respectively). Rats in the low-dose ZLT and placebo groups exhibited significantly lower serum phosphorus in comparison with the control rats (p = 0.005 and 0.03, respectively). Rats of the placebo group (EG + starch) encountered growth retardation, with their body weights slowly increasing, expressed as 160.63 +/- 23.06 g, compared with 179.63 +/- 13.41 g in normal rats (p < 0.001). CONCLUSION: ZLT reduced the severity of CaOx crystallization and slowed down the body weight loss effects. Therefore, the traditional Chinese medicine herbal formula ZLT may be an effective reagent for renal stone prophylaxis. Although the mechanism of ZLT in crystal inhibition remains unclear, macromolecules may be involved.

PMID: 19506417 [PubMed - indexed for MEDLINE]

Medical management of urolithiasis, what opportunity for phytotherapy?

Front Biosci. 2003 May 1;8:s507-14

Authors: Atmani F

Urolithiasis is the formation of stones in the urinary tract, causing pain and bleeding, and may lead to secondary infection. It is the third most common affliction of the urinary tract. Of many types of stones that are formed, the most common are calcium oxalate. The formation of such concretion encompasses several physico-chemical events beginning with crystal nucleation, growth, aggregation, and ending by retention within urinary tract. The mechanisms governing the induction of all these processes remain speculative. One of the important phenomena that characterizes urolithiasis is its high recurrence. Thus, a protective system is required including extracorporeal shock wave lithotripsy and medicament treatment. Unfortunately, these means remain costly and in most cases are invasive and with side effects. Therefore, it is worthwhile to look for an alternative to these conventional methods by using medicinal plants or phytotherapy. In fact, many developing countries including China use herbal medicines which have gained popularity in Europe and are becoming increasingly in the United States as well. As far as urolithiasis is concerned, several herbal treatments seem to cure lithiasis patients. Nevertheless, the effectiveness and the mechanism by which these plants work has not been fully undertaken by using scientific and objective methods. Therefore, it is highly recommended to explore new drugs coming from medicinal plants to treat and prevent the formation of kidney stones. Ideally, conventional and phytotherapy should supplement one another and have all the need available for lithiasis patients.

PMID: 12700097 [PubMed - indexed for MEDLINE]

Prophylaxis of calcium oxalate stones by Herniaria hirsuta on experimentally induced nephrolithiasis in rats.

BJU Int. 2003 Jul;92(1):137-40

Authors: Atmani F, Slimani Y, Mimouni M, Hacht B

OBJECTIVE: To evaluate the prophylactic potential of a herbal decoction from Herniaria hirsuta, a medicinal plant widely used in Morocco to treat kidney stones, by assessing the effect of oral administration in experimentally induced calcium oxalate (CaOx) nephrolithiasis in rats. MATERIAL AND METHODS: Two groups of six rats each were rendered nephrolithic by treating with ethylene glycol 0.75% and ammonium chloride 1% for 3 days, and then ethylene glycol only for 3 weeks. Maintained on ethylene glycol, one group of rats was also given 1 mL/day of the plant decoction, while the others received 1 mL of water instead for 2 weeks. Urine samples (24 h) were collected individually at 1, 3, 7, and 14 days for physicochemical analysis. On completing the treatment the kidneys were collected and analysed by light microscopy. RESULTS: The water intake and diuresis decreased in the treated rats; there was no significant difference in urinary pH between the groups. Urinary chemistry was apparently unaffected by the plant extract, except for the magnesium content, which was higher in treated rats. Crystalluria was characterized by the excretion of large CaOx monohydrate and dihydrate crystals in untreated, but smaller crystals in treated rats. The histology showed large deposits of CaOx crystals in all parts of the kidney in untreated rats but with almost no deposits in those of treated rats. CONCLUSION: H. hirsuta has an impressive prophylactic effect on CaOx stones in nephrolithic rats; the effect did not seem to be mediated by biochemical or diuretic changes.

PMID: 12823398 [PubMed - indexed for MEDLINE]

Movement disorders possibly induced by traditional chinese herbs.

Eur Neurol. 2003;50(3):153-9

Authors: Wang XP, Yang RM

The authors describe the neurological presentation and CT/MRI findings in 4 patients exposed to overdoses of decoctions of two different Chinese herbs. Case 1, a 15-year-old boy, ingested herba serissae along with the safe-dosage Salvia miltiorrhiza for treating a left renal stone. Sophora subprostrata root (SSR) was primarily used for treating three other diseases: viral B hepatitis in case 2, a 9-year-old boy; infection of the throat and a low fever in case 3, a 11-year-old girl, and a minor facial infection in case 4, a 12-year-old boy. All patients showed complex neurological manifestations primarily including convulsions, mental changes and dystonia syndromes. Their CT and/or MRI revealed abnormal density lesions in the striatum and globus pallidus bilaterally. They excluded the possibility of Wilson's disease in each of the 4 patients and suggested that overdosage of SSR and herba serissae could cause intoxications of the central nervous system, particularly damage to the basal ganglia. Chemically, coumarin (case 1) and matrine and oxymatrine (cases 2-4) in the two medicinal herbs are suggested to be possibly responsible for the morbidity.

PMID: 14530621 [PubMed - indexed for MEDLINE]

Pharmacological actions and potential uses of Momordica charantia: a review.

J Ethnopharmacol. 2004 Jul;93(1):123-32

Authors: Grover JK, Yadav SP

Since ancient times, plants and herbal preparations have been used as medicine. Research carried out in last few decades has certified several such claims of use of several plants of traditional medicine. Popularity of Momordica charantia (MC) in various systems of traditional medicine for several ailments (antidiabetic, abortifacient, anthelmintic, contraceptive, dysmenorrhea, eczema, emmenagogue, antimalarial, galactagogue, gout, jaundice, abdominal pain, kidney (stone), laxative, leprosy, leucorrhea, piles, pneumonia, psoriasis, purgative, rheumatism, fever and scabies) focused the investigator's attention on this plant. Over 100 studies using modern techniques have authenticated its use in diabetes and its complications (nephropathy, cataract, insulin resistance), as antibacterial as well as antiviral agent (including HIV infection), as anthelmintic and abortifacient. Traditionally it has also been used in treating peptic ulcers, interestingly in a recent experimental studies have exhibited its potential against Helicobacter pylori. Most importantly, the studies have shown its efficacy in various cancers (lymphoid leukemia, lymphoma, choriocarcinoma, melanoma, breast cancer, skin tumor, prostatic cancer, squamous carcinoma of tongue and larynx, human bladder carcinomas and Hodgkin's disease). There are few reports available on clinical use of MC in diabetes and cancer patients that have shown promising results.

PMID: 15182917 [PubMed - indexed for MEDLINE]

[The effects of the active constituents of Alisma orientalis on renal stone formation and bikunin expression in rat urolithiasis model]

Zhonghua Yi Xue Za Zhi. 2004 Aug 2;84(15):1276-9

Authors: Cao ZG, Liu JH, Zhou SW, Wu W, Yin CP, Wu JZ

OBJECTIVE: To evaluate the effects of the active constituents of Alisma orientalis on the expression of bikunin mRNA in rat urolithiasis model, and explore the mechanism of this traditional Chinese medicine on prevention of urinary calculi. METHODS: Modern phytochemistry and bioactivity guided isolation techniques were applied to extract the active constituents of Alisma orientalis. Hyperoxaluria and the renal oxalate calcium stone formation were induced in rats by infusion into the stomach with 1% ethylene glycol and 2% ammonium chloride. 30 adult male Wistar rats were randomized into 3 groups of 10 rats: control group, infused into the stomach with running water; stone-forming group, infused into the stomach with 1% ethylene glycol and 2% ammonium chloride so as to make into renal oxalate calcium stone model; and group of Alisma orientalis, infused into the stomach with 2% ammonium chloride and the constituents of Alisma orientalis. Four weeks after the rats were killed and their kidneys were taken out. Reverse transcription polymerase chain reaction technique was used to examine the bikunin mRNA expression levels in the rat renal tissues. The calcium oxalate deposits in the kidneys were detected by microscopy. The serum creatinnine and blood urea nitrogen levels, renal tissue calcium content, 24 h urinary calcium and oxalate excretion were also detected. RESULTS: In the group administered with the active constituents of Alisma orientalis, calcium oxalate deposits in the kidney, serum creatinnine and blood urea nitrogen levels, the bikunin mRNA expression levels, renal tissue calcium content and 24 h urinary calcium excretion were all significantly lower than those in the model group (the bikunin mRNA expression levels: 0.53 +/- 0.17 vs 0.71 +/- 0.25, P < 0.05; renal tissue calcium content: 4.70 mg/g +/- 0.08 mg/g vs 9.49 mg/g +/- 0.45 mg/g, P < 0.01; 24 h urinary calcium excretion: 37 micromol +/- 2 micromol vs 62 micromol +/- 2 micromol, P < 0.01). CONCLUSION: The active constituents of Alisma orientalis can down-regulate the bikunin mRNA expression, decrease the calcium oxalate formation in rat kidney, and inhibit the renal stone formation in rat urolithiasis model.

PMID: 15387965 [PubMed - indexed for MEDLINE]

[An experimental study of effect of different extracts of Alisma orientalis on urinary calcium oxalate stones formation in rats]

Zhongguo Zhong Yao Za Zhi. 2003 Nov;28(11):1072-5

Authors: Cao ZG, Liu JH, Radman AM, Wu JZ, Ying CP, Zhou SW

OBJECTIVE: To study the effect of different extracts of Alisma orientalis on urinary calcium oxalate stone formation in rats and to identify the effective constituents. METHOD: Different extracts were administered through a stomach tube to rats of different groups with renal calcium oxalate stones induced by ethylene glycol (EG) and ammonium chloride (AC). RESULT: In the rats administered with ethyl acetate elution of ethyl acetate extract, blood Cr, BUN, renal tissue calcium content, urinary calcium excretion and crystals deposition in renal tissue were significantly lower than those of the stone formation group. CONCLUSION: The ethyl acetate elution of ethyl acetate fraction extract of Alisma orientalis can significantly inhibit urinary calcium oxalate stone formation in rats and be the most effective constituent of Alisma orientalis.

PMID: 15615421 [PubMed - indexed for MEDLINE]