Abstract
ABSTRACT Phyllanthus niruri (P.niruri) or stone breaker is a plant commonly used to reduce stone risk, however, clinical studies on this issue are lacking.Objective:To prospectively evaluate the effect of P. niruri on the urinary metabolic parameters of patients with urinary lithiasis.Materials and Methods:We studied 56 patients with kidney stones <10mm. Clinical, metabolic, and ultrasonography assessment was conducted before (baseline) the use of P. niruri infusion for 12-weeks (P. niruri) and after a 12-week (wash out) Statistical analysis included ANOVA for repeated measures and Tukey's/McNemar's test for categorical variables. Significance was set at 5%.Results:Mean age was 44±9.2 and BMI was 27.2±4.4kg/m2. Thirty-six patients (64%) were women. There were no significant changes in all periods for anthropometric and several serum measurements, including total blood count, creatinine, uric acid, sodium, potassium, calcium, urine volume and pH; a significant increase in urinary potassium from 50.5±20.4 to 56.2±21.8 mg/24-hour (p=0.017); magnesium/creatinine ratio 58±22.5 to 69.1±28.6mg/gCr24-hour (p=0.013) and potassium/creatinine ratio 39.3±15.1 to 51.3±34.7mg/gCr24-hour (p=0.008) from baseline to wash out. The kidney stones decreased from 3.2±2 to 2.0±2per patient (p<0.001). In hyperoxaluria patients, urinary oxalate reduced from 59.0±11.7 to 28.8±16.0mg/24-hour (p=0.0002), and in hyperuricosuria there was a decrease in urinary uric acid from 0.77±0.22 to 0.54±0.07mg/24-hour (p=0.0057).Conclusions: P.niruri intake is safe and does not cause significant adverse effects on serum metabolic parameters. It increases urinary excretion of magnesium and potassium caused a significant decrease in urinary oxalate and uric acid in patients with hyperoxaluria and hyperuricosuria. The consumption of P.niruri contributed to the elimination of urinary calculi.
Highlights
Risk factors for urolithiasis include congenital, genetic, environmental, dietary and metabolic aspects; chronic diseases including obesity, hypertension and diabetes are associated with urinary calculus formation [1]
Urinary ibju | Effect of phyllanthus niruri on metabolic parameters calculi derive from a combination of some of the factors involved in its pathophysiology [1]
The P. niruri stage consisted of 12 weeks of ingestion of an infusion tea prepared with the dry extract of P. niruri, according to literature recommendations [13], a week of rest was included without using the plant after each week of consumption (2 weeks)
Summary
Risk factors for urolithiasis include congenital, genetic, environmental, dietary and metabolic aspects; chronic diseases including obesity, hypertension and diabetes are associated with urinary calculus formation [1]. Urinary ibju | Effect of phyllanthus niruri on metabolic parameters calculi derive from a combination of some of the factors involved in its pathophysiology [1]. Knowledge of the pathophysiological mechanisms involved and their risk factors, such as low urinary volume and high intake of calories, sodium and protein are important for modifying the natural history of the disease [2]. A reduction in the recurrence of urinary calculi of at least 50% can be achieved with dietary guidelines, lifestyle changes and the use of specific medications [4, 5]
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