A Critical Review on Antiurolithiatic Activity of Bioactive Phytoconstituents

Author(s):  
Dheepa Anand ◽  
Chandrasekar R ◽  
Sivagami B

New drugs are introduced in the market every year and new diseases are emerging every year and there is no cure for existing diseases. Though new drugs are being approved by the FDA every year, controlling emerging infections is a global concern. Due to increased side effects and toxicity the modern world is turning towards herbal medicine. Due to few reasons like global warming, food habits and modern life style disease like Urolithiasis places a significant economic burden on the healthcare system, especially in developed and developing countries where, owing to changes in food habits and lifestyle, the prevalence of stone disease has significantly increased over the last few decades; unfortunately, it will probably continue to increase for a number of reasons. Despite considerable improvements in the development of new herbal therapies for the management of urinary stones, the incidence of urolithiasis is increasing worldwide. However, it is evident that crystal retention, cell apoptosis, renal cell injury, and associated stone promoters or inhibitors play important roles for kidney stone formation. In addition, the identification of novel phytoconstituents on the basis of molecular and cellular alterations in relation to stone formation will help develop better herbal remedies. Moreover, better understanding of the mechanisms of urolithiasis associated with stone inhibitors or promoters will be critical for stone-removing medications. This review encompasses different medicinal plants, polyherbal formulations and phytoconstituents used in the treatment of Kidney stones. More interdisciplinary research is needed to develop new plant-derived high-quality natural products to treat and prevent the formation of kidney stones.

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1917
Author(s):  
Roswitha Siener

The prevalence of kidney stone disease is increasing worldwide. The recurrence rate of urinary stones is estimated to be up to 50%. Nephrolithiasis is associated with increased risk of chronic and end stage kidney disease. Diet composition is considered to play a crucial role in urinary stone formation. There is strong evidence that an inadequate fluid intake is the major dietary risk factor for urolithiasis. While the benefit of high fluid intake has been confirmed, the effect of different beverages, such as tap water, mineral water, fruit juices, soft drinks, tea and coffee, are debated. Other nutritional factors, including dietary protein, carbohydrates, oxalate, calcium and sodium chloride can also modulate the urinary risk profile and contribute to the risk of kidney stone formation. The assessment of nutritional risk factors is an essential component in the specific dietary therapy of kidney stone patients. An appropriate dietary intervention can contribute to the effective prevention of recurrent stones and reduce the burden of invasive surgical procedures for the treatment of urinary stone disease. This narrative review has intended to provide a comprehensive and updated overview on the role of nutrition and diet in kidney stone disease.


1998 ◽  
Vol 9 (9) ◽  
pp. 1645-1652
Author(s):  
G C Curhan ◽  
W C Willett ◽  
E B Rimm ◽  
F E Speizer ◽  
M J Stampfer

A variety of factors influence the formation of calcium oxalate kidney stones, including gender, diet, and urinary excretion of calcium, oxalate, and uric acid. Several of these factors may be related to body size. Because men on average have a larger body size and a threefold higher lifetime risk of stone formation than women, body size may be an important risk factor for calcium oxalate stone formation. The association between body size (height, weight, and body mass index) and the risk of kidney stone formation was studied in two large cohorts: the Nurses' Health Study (NHS; n = 89,376 women) and the Health Professionals Follow-up Study (HPFS; n = 51,529 men). Information on body size, kidney stone formation, and other exposures of interest was obtained by mailed questionnaires. A total of 1078 incident cases of kidney stones in NHS during 14 yr of follow-up and a total of 956 cases in HPFS during 8 yr of follow-up were confirmed. In both cohorts, the prevalence of a stone disease history and the incidence of stone disease were directly associated with weight and body mass index. However, the magnitude of the associations was consistently greater among women. Specifically, the age-adjusted prevalence odds ratio for women with body mass index > or = 32 kg/m2 compared with 21 to 22.9 kg/m2 was 1.76 (95% confidence interval, 1.50 to 2.07), but 1.38 (95% confidence interval, 1.16 to 1.65) for the same comparison in men. For incident stone formation, the multivariate relative risks for the similar comparisons were 1.89 (1.51 to 2.36) for women and 1.19 (0.83 to 1.70) in men. Height was inversely associated with the prevalence of stone disease but was not associated with incident stone formation. These results suggest that body size is associated with the risk of stone formation and that the magnitude of risk varies by gender. Additional studies are necessary to determine whether a reduction in body weight decreases the risk of stone formation, particularly in women.


2020 ◽  
Vol 73 (9) ◽  
pp. 2031-2039
Author(s):  
Łukasz Dobrek

Kidney stone disease (nephrolithiasis; urolithiasis) is a clinical entity with long-term course and recurrence, primarily affecting mature and ageing men, involving the formation and presence of urinary stones in the kidneys and urinary tract. The pathogenesis of this disorder is complex and still not fully understood. A rare, potentially modifiable, form of kidney stone disease takes the form of drug-induced urinary stones. The aim of the review was a brief description of the classification and pathophysiology of kidney stone disease, along with the short characteristics of drug-induced urinary stones. This type of stones is formed as a result of crystallisation in the kidneys and urinary tract of sparingly soluble drugs and their metabolites, or as a result of metabolic changes caused by drugs, predestinating the development of stones containing endogenous compounds. Conclusion: Therefore, during treatment with the use of drugs with high lithogenic potential, the safety of pharmacotherapy should be monitored in the context of its increased risk of developing urinary stones.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Matteo Bargagli ◽  
Rossella De Leonardis ◽  
Mauro Ragonese ◽  
Angelo Totaro ◽  
Francesco Pinto ◽  
...  

Abstract Background and Aims Nephrolithiasis is a medical condition characterized by high prevalence among the general population both in Europe and in the U.S. and it is responsible for high costs reaching up to $10 billion per year. It is associated with specific comorbidities such as obesity, arterial hypertension, diabetes mellitus, metabolic syndrome and chronic kidney disease. Kidney stones development is believed to start either from Randall’s plaques or from stone plugs. Both these lesions can be seen on renal papillary surfaces, but what promotes the formation of plaques and plugs is not entirely understood. The aim of this study is to investigate the association between the urinary metabolic milieu and a published endoscopic papillary evaluation score (PPLA). We also evaluated the correlation of PPLA score with kidney stone recurrence during follow-up. Method We prospectively enrolled 31 stone forming patients who undergone retrograde intrarenal surgery procedures. Visual inspection of the accessible renal papillae was performed in order to calculate the PPLA score based on the appearance of ductal plugging, surface pitting, loss of papillary contour and Randall’s plaque extension. Demographic information, blood samples, 24h urine collections and kidney stone events during follow-up were collected. Stone composition was analyzed using infrared-spectroscopy. Relative urinary supersaturations (RSS) for calcium oxalate (CaOx), calcium phosphate (CaPi) and uric acid (UA) were calculated using the Equil2 software. PPLA score > 3 was defined as high. Results Median follow-up period was 11 (min/max 5, 34) months. PPLA score was inversely correlated with BMI (rho = −0.39, p = 0.035) and history of recurrent kidney stones (median PPLA 5.0 vs 2.5, p = 0.029), these results were confirmed when PPLA was considered as a categorical variable (median BMI 27 vs 24, recurrent stone disease 12 vs 62%, p= 0.006). Furthermore, high PPLA score was associated with lower odds of new kidney stone events during follow-up (OR 0.154, 95% confidence interval 0.024, 0.998, p = 0.05). No significant correlations were found between PPLA score, stone composition, blood parameters, 24h urine solute excretions and RSS for CaOx, CaPi and UA. Conclusion Different papillary abnormalities seem to be linked to specific mechanisms of stone formation. Although data regarding PPLA score are inconsistent, it may be a valid asset for both medical and surgical management of nephrolithiasis. Larger, long-term prospective clinical studies need to be conducted to assess the validity of PPLA score system in evaluating risk of stone recurrence.


Author(s):  
Yogesh Kumar Sharma ◽  
Umesh Kumar Gilhotra

Urolithiasis is the urinary disorder characterized by formation of stone in the urinary tract, urinary bladder and kidneys. Urolithiasis is considered to be a risk of urinary incontinence and may be associated with urinary incontinence. A urinary stone commonly occurs in males and are calculated on the basis of their mineral composition. Approximately 80% of urinary stones composed as calcium oxalate and calcium phosphate. Urinary calculi can cause disruption to the urinary system, hydrophoresis, infections and bleeding. Root stone formation is the result of several mechanisms. Whereas exceeding supersaturation (i.e. free stone formation) is the cause of uric acid or cystine calculi, infection stones result from bacterial metabolism. Renal calculi can be broadly classified in two large groups: tissue attached and unattached. Components in diet increase the risk of stone formation include low intake of fluid and animal protein, sodium, sugar and syrup high corn fruit, oxalate, grape juice, apple juice and cola drinks.   Vegetarian diets, spices and liquids may be helpful in treating and prevention and kidney stones. Therefore, the best way to prevent kidney stones is to consume a lot of water and a magnesium rich vegan. Common medications used to prevent urolithiasis do not work for all patients, and many have adverse effects that endanger their long-term use.  Managing today's urolithiasis with open renal surgery is unusual and rarely used, only by the introduction of Extracorporeal Shock wave lithotripsy (ESWL) is useful but it is expensive. Herbs and herbal medicines have created interest among people with its clinically proven effects such as immunomodulation and antimutagenic. Also, abusing synthetic drugs due to serious side effects of the drug has allowed humans to return to nature for safe treatment. Kew words: hydrophoresis, Urolithiasis


2020 ◽  
Vol 06 ◽  
Author(s):  
Ankit Yadav ◽  
Rina Das ◽  
Dinesh Kumar Mehta ◽  
Yatin

: Kidney stone formation or Urolithiasis is a common problem over many centuries with no guarantee of effective treatment and, a high recurrence rate. Urolithiasis is precipitation of insoluble and less soluble salt such as Oxalate and Phosphate in the urinary tract causing obstruction in the urethra resulting in renal colic and, hematuria. Approximately, 10-12% of the population in industrialized countries are severely affected by Urinary stones. In, only a few geographical areas is stone disease rare, e.g., in the coastal areas of Japan and Germany. It was believed that, 11% of people in India are suffering from urinary stone problems, and approximately 50% of these cases may lead to severe renal damage. Ultimately it causes severe health issues in terms of urinary tract obstruction, severe pain, and infection that adversely affects the health of individuals. Diuretics and narcotic analgesic like drugs which are used to prevent and cure urolithiasis are not effective in all cases and are costly, give quite common recurrences, risk long term fertility and, other potential side effects are observed. So, humans are forced return to Nature for safe remedies using herbal treatment. A great number of Indian medicinal plants have been investigated in the treatment of urolithiasis, and they have been reported to be safe and effective. In the present review, an effort has been made to highlight such herbal medicines which are potentially effective in the management of urolithiasis.


2020 ◽  
pp. 039156032096620
Author(s):  
Elisa Cicerello ◽  
Mario S Mangano ◽  
Giandavide Cova ◽  
Matteo Ciaccia

Although nephrolithiasis is a more common disease in men rather than women, several studies over the last decades show that the male to female ratio 3:1 is narrowing. These finding may be associated to modified risk factors for stone formation between females and males. Changes in lifestyle and increasing obesity in women may play a role in shifting of gender disparity. Furthermore, recent studies have demonstrated an increase of kidney stones in women which have necessitated emergency department visits (ED). Therefore, females show a greater percentage of mortality rate if compared to males, especially if stone disease is associated to urosepsis and requires the admission to the Intensive Care Unit (ICU). This article reviews recent insights into changing gender prevalence in urinary calculi and into identifying the relation between gender and risk factors for stone disease, that in case of severe urosepsis might also lead to mortality.


2019 ◽  
Vol 3 (s1) ◽  
pp. 54-54
Author(s):  
Damian Nicolas Di Florio ◽  
Erika J. Douglass ◽  
Katelyn A. Bruno ◽  
Anneliese R. Hill ◽  
Jessica E. Mathews ◽  
...  

OBJECTIVES/SPECIFIC AIMS: More men than women develop urinary stones and their prevalence alters in women with menopause suggesting a steroidal influence. In men the incidence of stones is highest during July and August suggesting that environmental factors such as Vitamin D (VitD), a steroid, may affect stone formation. Previous studies have found differences in the development of stones between men and women; however, the reasons for sex differences in stone formation and type remain unclear. METHODS/STUDY POPULATION: We examined VitD levels in men and women (n = 18,753) that had no diseases based on a lack of an ICD-9 or ICD-10 code in their electronic medical record. We found that normal, healthy women had significantly higher levels of sera VitD compared to men (p = 6x10-6). We then examined whether sex differences existed for key endpoints/data from the Mayo Clinic Urinary Stone Disease (USD) Registry, which has around 1,600 urinary stone patients that are well-phenotyped according to sex, age and stone type. RESULTS/ANTICIPATED RESULTS: Control women were found to have higher sera VitD levels than men, but the sex difference no longer exists in kidney stone disease patients. When we further separated by race, we found that differences in VitD levels reappeared; this suggests that race also plays a role in sera VitD variances. DISCUSSION/SIGNIFICANCE OF IMPACT: We are developing a disease severity score, which we will use to correlate to sera VitD levels in patients according to sex, age and race. Future analyses will take into account whether subjects had VitD and calcium supplementation. This project begins to explore the mechanism behind the sex differences known to exist in urinary stone disease, which is critically needed to provide improved diagnosis and therapy for this debilitating disease.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
C Lovegrove ◽  
T Littlejohns ◽  
N Allen ◽  
S Howles ◽  
B Turney

Abstract Aim To investigate the relationship between measures of adiposity and risk of incident kidney stone disease. Method The UK Biobank is a prospective cohort study of ∼500,000 participants whose height, weight, BMI, waist circumference, hip circumference, waist:hip ratio (WHR), total fat mass, fat-free mass, body-fat percentage, and percentage truncal fat were measured at enrolment with linkage to medical records. ICD-10 and OPCS codes identified individuals with a new diagnosis of nephrolithiasis from 2006-2010. Individuals with a history of kidney stones or incomplete data were excluded. Multivariate Cox-proportional hazard models were used to assess associations between anthropometric measures and incident kidney stones. Results From the UK Biobank, 493,410 individuals were identified for inclusion; 3,466 developed a kidney stone during the study period. Increasing weight, BMI, waist, and hip circumferences, WHR, and body and truncal fat were all associated with increased risk of incident kidney stone disease. However, after adjustment for BMI, only waist circumference and WHR remained significantly associated with risk of nephrolithiasis. In overweight patients, high (men 94-102cm, women 80-88cm) waist circumference or WHR (men >0.9, women >0.85) conferred >40% increased risk of stone formation. Conclusions This study indicates that android fat distribution is independently associated with increased risk of developing nephrolithiasis. Kidney stone disease is known to be associated with hypertension, cardiovascular disease, and diabetes, all of which have been linked to android body shape. Our findings provide insight into anthropometric risk factors for stone disease, will facilitate identification of patients at greatest risk of stone recurrence, and will inform prevention strategies.


2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
Tilahun Alelign ◽  
Beyene Petros

Kidney stone disease is a crystal concretion formed usually within the kidneys. It is an increasing urological disorder of human health, affecting about 12% of the world population. It has been associated with an increased risk of end-stage renal failure. The etiology of kidney stone is multifactorial. The most common type of kidney stone is calcium oxalate formed at Randall’s plaque on the renal papillary surfaces. The mechanism of stone formation is a complex process which results from several physicochemical events including supersaturation, nucleation, growth, aggregation, and retention of urinary stone constituents within tubular cells. These steps are modulated by an imbalance between factors that promote or inhibit urinary crystallization. It is also noted that cellular injury promotes retention of particles on renal papillary surfaces. The exposure of renal epithelial cells to oxalate causes a signaling cascade which leads to apoptosis by p38 mitogen-activated protein kinase pathways. Currently, there is no satisfactory drug to cure and/or prevent kidney stone recurrences. Thus, further understanding of the pathophysiology of kidney stone formation is a research area to manage urolithiasis using new drugs. Therefore, this review has intended to provide a compiled up-to-date information on kidney stone etiology, pathogenesis, and prevention approaches.


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