Review Article

March-April 2017  |  Vol: 3  |  Issue: 2
A Review On Anti-Urolithiatic Activity Of Herbal Folk Plants

Ajay Kumar Shukla, Surat Shukla, Ashish Garg, Sweta Garg

Mohanlal Sukhadia University Udaipur 313001 Rajasthan India

Maya Ram Degree College Singrauli 486889 Madhya Pradesh India

 

Department of Pharmaceutical Science, Guru Ramdas Khalsa Institute of Science & Technology Pharmacy, Jabalpur, India

*Address for Corresponding Author:

Mr. Ajay shukla

Department of Pharmaceutical Science,

Mohanlal Sukhadia University,

Udaipur Rajasthan, India

Email: ashukla1007@gmail.com

 

Abstract

Objective: Urolithiasis is a common problem of various centuries with high recurrence. The present review is an attempt to share traditionally used antiurolithiatic plants with their mechanism of action. Chemical principles from herbal sources have become much simpler and have contributed significantly to the development of new drugs from medicinal plants. Urolithiasis is a common disorder expected to occur in approximately 12% of the population, with a recurrence rate of 70-81% in males, and 47-60% in females. It causes serious health problems such as severe pain, urinary tract obstruction and infection that adversely affect well-being of individuals. Treatment option includes like surgical, ureteroscopy, percutaneous nephrostolithotomy (PCNL), and open or laparoscopic stone removal which are costly and painful. Many synthetic drugs used like diuretics and narcotic analgesics are being used in treatment of kidney stone but overuse of synthetic drugs, which produce higher incidence of adverse drug effect, have forced humans to return to nature for safe remedies herbal treatment. Conclusion: The present review covered all the information about litholytic medicinal plants. The use of herbal remedies for prevention and cure of ailments is of increasing interest due to the superiority and efficiency of activity provided by natural constituents in herbs and undesirable effects of modern medicine. Evidences prove that natural therapy is more valuable than other available treatments, with lesser side effects, economic nature, no risk of long term fertility and reoccurrence. We covered all potent indigenous herbs which are used in treatment of urolithiasis disease. This review will give the opportunities for the future research and for the development of new antiurolithiatic compounds.

Keywords: Medicinal Plants, Urolithiasis, Adaptogenic, Preclinical studies

 

Introduction

Stone formation is one of the painful urologic diseases that occur in around

12% of the global population and its occurrence rate in males is 70-81% and 47-60% in female (Soundararajanetal.,2006).

It is assessed that at least 10% of the population in industrialized part of the world are suffer with the problem of urinary stone formation. The occurrence of the renal calculi is less in the southern part when compared with other parts (Singh et al., 2010). The rate of occurrence is three times more in men than women, due to enhancing capacity of testosterone and inhibiting capacity of oestrogen hormone in stone formation (Devi et al., 1993). It has been found that the development of urinary calculi dates back not only to 4000 B.C in the tombs of Egyptian mummies also in graves of North American Indians from 1500 to1000 B.C (Bahuguna et al., 2009). The problem of stone formation is careful as a medical challenge due to its multifactorial etiology and high rate of reoccurrence. Stone formation is also caused due to imbalance system of body. From ancient periods, a number of herbal medicines have been established with potential effect in treating the problem of renal calculi (Khan et al., 2010). Scientific studies expose the mechanism action, these antiurolithiatic herbal plants and responsible for at different stages of urolithiasis, such as, the diuretic action increases the quantity of fluid going pass through the kidneys as a consequence flush out the deposits. as a result, the increase in urine volume decreases the saturation of the salts and prevents the precipitation of the crystals at physiological pH. Breaking, disintegration and dissolution of preformed stones (litholytic activity) and binding inhibition among particles to form stones (lithotriptic activity) play an important role in this pathological condition. Crystal inhibitors decrease crystal nucleation, aggregation and growth. Furthermore, they inhibit crystallization by their adsorption to the crystal surface which makes them unable for renal tubular attachment (crystallization inhibition activity) (Pareta et al., 2011).

Reasons for stone formation diseases

Stone formation usually occur due to insufficient urinary discharge, microbial infection in urinary tract, diet with excess oxalates and calcium, vitamin abnormalities like vitamin A deficiencies, excess vitamin D, and metabolic diseases like hyperthyroidism, cystinuria, gout, intestinal dysfunction etc.,( Suman Kumar Mekap 2011). Kidney stone formation or urolithiasis is a complex procedure that occurs due to imbalance between promoters and inhibitors in the kidneys. The factor affecting stone formation are urine output (hence the concentration).The concentration of specific constituent, urine pH, and infection or damage within the urinary tract (Michell et al., 1989).

Pathophysiology of urolithiasis diseases

There are basic two aspects in the pathogenesis of kidney stone like as

(a) Increased urinary flow of stone forming constituent elements like calcium, phosphorus, uric acid, oxalate and cysteine.

(b) Physico-chemical change that influence stone formation like pH of urine, stone matrix and protective substance in urine.

For a stone to form within the urinary tract, Urine must be supersaturated for precipitating crystalline component. The agents who can modify nucleation, crystallization, and aggregation, pH of the urine also play important role in stone formation (Malhotra et al., 2008)

Signs and symptoms of urolithiasis diseases

Symptoms like as of kidney stones include- Colicky pain, Nausea/vomiting Hematuria, Pyuria, Dysuria, Oliguria etc.

Diagnosis of urolithiasis diseases

Following technologies used such as x-ray, computed tomography, ultrasound is used to verify the diagnosis and a number of other tests can be undertaken to help found both the possible cause and consequences of the stone.

 

Ttreatment and prevention of urolithiasis diseases

For treatment of urolithiasis various types of procedure is carried out. 1. Surgical treatment likes (a) Shock wave treatment which is the only non-invasive treatment for stone disease,

(b) Endoscopic process, ureterenooscopic and percutaneous nephrolithotomy provides an efficient way to treat stones. The severe nature of renal colic has promoted a lower threshold at which narcotic analgesic, thiazide like diuretic and potassium citrate is prescribed (Orson et al., 2006)

Following foods enhance the risk of calculi formation

1. Fruit juices like Grape fruit juice, cranberry juice, and apple juice and dark colas

2. Organic acids rich foods (oxalates) like spinach, rhubarb, nuts and wheatbran.

3. Animal protein rich foods like meat, eggs and fish

4. Others like vitamin C & D

5. Alcohol, Beer and wine to a little extent as they contain purines High intake of salt

Following foods that inhibit calculi formation

1. Lemon and citrus fruit juice, coffee, tea and citrates rich soft drinks

2. Foods like as radish, beet root and horse gram

3. Low protein diet and rich fiber foods

4. Others like Vitamin E, B6, and magnesium

5. Low salt diets

Available treatments

1. Medicine Therapy

Like as Thiazide diuretics (e.g. Hydrochlorothiazide), Alkali (e.g. Potassium citrate), Allopurinol, Sodium cellulose phosphate (SCP), Penicillamine (Cuprimine), Analgesic (Diclophenac sodium), Bisphosphonates,

 

Potassium phosphate, Oxalobacter Formigenes and other probiotics etc.

2. Surgical Therapy

Like as Extracorporeal Shock Wave Lithotripsy, Percutaneous Nephrolithotomy, Ureteroscopic stone removal etc.

3. Herbal Therapy

Like as Cystone, Calcuri, Chandraprabha bati, Trinapanchamool, Rencare Capsule, Patherina tablet, Ber Patthar Bhasma, Chander Prabha vati etc.

Herbal folk drugs produce following actions such as:

1. Diuretic activity (Beneficial in increasing the urinary volume that allows the easy passage of small calculi out of the body in urine)

2. Crystallization inhibition activity (Helps to inhibit the different stages of stone formation by maintaining the balance between inhibitors and promoters of stone formation)

3. Lithotriptic activity (Avoid binding mucin of calculi to prevent crystal aggregation to form a large stone), analgesic and anti inflammatory activities (Helps to escape the symptoms of stone formation) 4. Anti oxidant activity (Prevent renal tissue injury), Anti microbial activity (Prevent the occurrence of infections) (Charde et al., 2011)

5. Herbs also improve the renal function and regulate oxalate metabolism which help in reducing the re occurrence of renal calculi (Pareta et al., 2011).

Herbal folk drugs used in treatment of urolithiasis

Number of herbal folk drugs shows antiurolthiatic activity and play vital role in prevention of disease. Here an attempt has been made to emphasis on potent indigenous herb for urinary stone (Havagiray et al., 2010).

 

 

 

 

 

 

 

Table 1. Herbal folk drugs used in treatment of urolithiasis.

          Botonical name

Family

Plant part

 

References

Acalypha indica Linn.

Euphorbiaceae

Whole plant

 

Sathyaa et al., 2011

Abutilon indicum L.

 

Leaf juice

 

Prachi et al., 2009

Achyranthes aspera L.

Amaranthaceae

Roots

 

Aggarwal et al., 2010

Achyranthes indica Linn.

Amaranthaceae

Roots

 

Pareta et al., 2011

Aegle marmelose L.Corr.

Rutaceae

Fruit pulp, Leaves.

 

 

Ghatapanadi et al., 2010

Aerva lanata L.

Amaranthaceae

Whole plant

 

Soundararajan et al., 2006

Ageratum conzoides L.

Asteraceae

Whole plant

 

Khan et al., 2011

Alhagi mannifera Desv (L.)

Fabaceae

Roots

 

Choubey et al., 2010

Alismatis rhizome (Sam.) Juzepcz.

Alismataceae

Whole plant

 

Koji et al., 1999

Amaranthus caudatus L.

Amaranthaceae

Leaves

 

Sharma et al., 2011

Amaranthus spinosus L.

Amaranthaceae

Roots

 

Sharma et al., 2011

Amaranthus viridis L.

Amaranthaceae

All parts

 

Sharma et al., 2011

Ammannia baccifera Linn

Lythraceace

Leaves

 

Prasad et al., 1994

Amni visnaga (L.) Lam

Apiaceae

Whole plant

 

Yadav et al., 2011

Argemone maxicana L.

Papaveraceae

Roots

 

Ghatapanadi et al., 2010

Armoracia lopathifolia Gilib.

Cruciferae

Seeds

 

Choubey et al., 2010 

Asperagus racemosus Willd.

Asperagaceae

Roots

 

Kumar et al., 2009 

Asphodelus tenuifolius Cav.

Liliaceae

Leaves

 

Sharma et al., 2011

Barbarea vulgaris R.Br.

Brassicaceae

Roots, Leaves

 

Choubey et al., 2010 and

Garg et al., 2016.

Benincasa Hispida (Thumb)

Cucurbitaceae

Seeds

 

Patel et al., 2011

Berberis vulgaris L.

Berberidaceae

Root bark

 

Bashir et al., 2010

Bergenia ciliata Wall.

Saxifragaceae

Rhizomes

 

Saha et al., 2011

Bergenia ligulata Wall.

Saxifragaceae

Rhizomes

 

Harsoliya et al., 2011

Beta vulgaris L.

Amaranthaceae

Roots

 

Sharma et al., 2011

Bombex ceiba Linn.

Bombacaceace

Stem and bark

 

Sharma et al., 2011

Borrhaavia diffusa L.

Nyctaginaceace

Root

 

Prachi et al., 2009

Bridelia crenulata Roxb.

Euphorbiaceae

Stem bark

 

Singh et al., 2007

Bryophyllum calycinum Salisb.

Crassulaceae

Leaves

 

Singh et al., 2007

Bryophyllum pinnatum (lamk.) oken.

Crassulaceae

Fresh leaf juice

 

Prachi et al., 2009

Caesalpinia huga L.

Caesalpiniaceae

Root

 

Chitme et al., 2010

Capsella bursapastor L. Medik

Brassicaceae

Entire herb

 

Choubey et al., 2010 

Cassia fistula L.

Caesalpinioideae

Fruits

 

Ghatapanadi et al., 2010

Cedrus deodara Roxb.

Pinaceae

Heart wood

 

Ramesh et al., 2010

Ceropegia bulbosa Roxb.

Asclepidaceace

Tubers

 

Sharma et al., 2011

Chenopodium album Linn.

Chenopodiaceace

Leaves

 

Sharma et al., 2011

Corbichonia decumbens Forrsk.(Jack).

Molluginaceace

Leaves

 

Sharma et al., 2011

Costus speciosus Koen.

Costaceace

Tubers

 

Sharma et al., 2011

Costus spiralis (jacq) Roscoe

Zingiberaceae

Whole plant

 

Araujo viel et al., 1999

Crateava nurvula Buch-Ham

Capparaceae

Bark

 

Prachi et al, 2009 

Cucumis sativus L.

Cucurbitaceae

Leaves

 

Choubey et al., 2010

Cyclea peltata Lam

Menispermaceae

Root

 

Christina et al.,2002

Cynodon dactylon Linn.

Poaceae

Root

 

Prachi et al., 2009

Daucus carota Linn.

Apiaceae

Gajar juice

 

Prachi et al., 2009 

Desmodium styracifolium(osbeck) Merr.

Leguminosae

Whole plant

 

Hirayama et al., 2008

Dichrostachys cinerea L.

Mimosaceae

Root

 

Jayakumari et al., 2011

Didymocarpus pedicellata Roxb.

Gesneriaceae

Leaves

 

Singh et al., 2007 

Digera muricata L.

Amaranthaceace

Leaves

 

Sharma et al., 2011

Diospyros melaoxylon Roxb.

Ebenaceace

Fruit, Flower and bark

 

Sharma et al., 2011

Dolichous biflorus L.

Fabaceae

Seeds

 

Singh et al., 2010 

Eleusine coracana Gaertn.

Poaceae

Grains

 

Bahuguna et al., 2009 

Equisetum debile Roxb.

Equisetaceace

All parts

 

Sharma et al., 2011

Ficus carica L.

Moraceae

Fruit, Latex

 

Choubey et al., 2010

Gomphrena celosioides Mart.

Amaranthaceace

Whole plant

 

Sharma et al., 2011

Grewia flavescens A. Juss

Tiliaceace

Roots

 

Sharma et al., 2011

Helianthus annus Linn

Asteraceae

Leaves

 

Khan et al., 2010 

Helichrysum plicatum DC.

Asteraceae

Flowers

 

Bayir et al., 2011

Herniaria hirsute Linn

Illecebraceae

Whole plant

 

Yadav et al., 2011

Homonoia riparia Lour.

Euphorbiaceae

Root

 

Chitme et al., 2010 

Ichnoccarpus frutescens L.

Apocynaceae

Roots

 

Anbu et al., 2011 

Lantana camara Linn

Verbenaceae

Leaves

 

Mayee et al., 2011 

Lawsonia inermis Linn

Lythraceae

Leaves

 

Kore et al., 2011

Macrotyloma uniflorum Lam.

Fabaceae

Seeds

 

Chaitanya et al., 2010

Mentha piperita L.

Lamiaceae

Entire herb

 

Choubey et al., 2010 

Mimusops elengi L.

Sapotaceae

Bark

 

Purnima Ashok et al., 2011 

Momordica charantia Linn

Cucurbitaceae

Fruits

 

Shah et al., 2011

Moringa oleifera Lam

Moringaceae

Pods, Bark, Root wood.

 

Vijayalakshmi et al., 2010

Musa bulbisiana Colla.

Musaceae

Roots

 

Prachi et al., 2009 

Musa paradisica Linn

Musaceae

Ripe kernel juice

 

Devi et al., 1993

Nigella sativa L.

Ranunculaceae

Seeds

 

Harsoliya et al., 2011

Olea europeae L.

Oleaceae

Oil

 

Choubey et al., 2010 

Ocimum sanctum

Parmelia perlata L.

Lamiaceae

Parmeliaceae

Leaves

Dried lichen

 

Garg et al., 2016

Chitme et al., 2010 

Paronychia argentea Lam.

Caryophyllaceae

Aerial parts

 

Bouanani et al., 2010 

Pedalium murex Linn.

Pedaliaceae

Fruits

 

Anantha et al., 2011 

Pergularia daemia Forssk.

Asclepiadaceae

Whole plant

 

Vyas et al., 2011

Phyllanthus fraternus Webster.

Euphorbiaceae

Whole plant

 

Ghatapanadi et al., 2010

Phyllanthus niruri L.

Euphorbiaceae

Whole plant

 

Mirian et al., 2010 

Pimpinella anisum L.

Apiaceae

Fruit

 

Choubey et al., 2010 

Pinus eldarica Medw.

Pinaceae

Fruits

 

Hosseinzadeh et al., 2010 

Plantago major L.

Plantaginaceae

Whole plant

 

Sharifa Abdul Aziz et al., 2005 

Pyracantha crenulata Roem.

Rosaceae

Fruit

 

Bahuguna et al., 2009

Pyracantha crenulated (Hance) Rehder

Rosaceae

Leaves

 

Yadav et al., 2011 

Raphanus sativus Linn

Cruciferae

Bark

 

Vargas et al., 1999

Ricinus communis Linn.

Euphorbiaceae

Root

 

Sharma et al., 2011

Rosmarinus officinalis L.

Lamiaceae

Leaves

 

Choubey et al., 2010

Rotula aquatica Lour.

Boraginaceae

Roots

 

Gilhotra et al., 2011 

Rubia cordifolia L.

Rubiaceae

Roots

 

Divakar et al., 2010

Santalum album L.

Santalaceae

Oil

 

Choubey et al., 2010 

Sesamum indicum L.

Pedaliaceae

Tender leaves

 

Ghatapanadi et al., 2010

Sesbania grandiflora L.

Fabaceae

Leaf juice

 

Sujatha Doddola et al., 2008

Solanum Indicum Linn.

Solanaceae

Roots

 

Prachi et al., 2009

Solanum surattense Burn.

Solanaceae

Roots

 

Sharma et al., 2011

Solanum xanthocarpum Schrad & Wendi.

solanaceae

Berries

 

Patel et al., 2010 

Tamarindus indica Linn.

Fabaceae

Fruit pulp

 

Kumar et al., 2009 

Terminalia arjuna Roxb.

Combrataceae

Bark

 

Chaudhary et al., 2010

Tinospora cordifolia Willd (L.)

Menispermeaceae

Stems

 

Ghatapanadi et al., 2010

Trachyspermum ammi L.

Umbelliferae

Seeds

 

Kaur et al., 2009

Trianth0ema portulacastrum Linn.

Ficoidae

Fresh leaf juice

 

Prachi et al., 2009

Tribulus terrestris L.

Zygophyllaceae

Fruits, Roots

 

Satish et al., 2010

Tridex procumbens L.

Asteraceae

Whole plant

 

Sailaja et al., 2011

Tubiflora acaulis L.F Kuntze.

Acanthaceae

Leaves

 

Sharma et al., 2011

Zea mays Linn.

Poaceae

Decoction of styles obtained from female inflorecence or immature cells.

 

 

 

 

Prachi et al., 2009 

Zingiber officinale Rosc.

Zingiberaceae

rhizomes

 

Prachi et al., 2009

 

 

 

 

Conclusion

The present review covered all the information about litholytic medicinal plants. The use of herbal remedies for prevention and cure of ailments is of increasing interest due to the superiority and efficiency of activity provided by natural constituents in herbs and undesirable effects of modern medicine. Evidences prove that natural therapy is more valuable than other available treatments, with lesser side effects, economic nature, no risk of long term fertility and reoccurrence. As there are no satisfactory drugs in modern medicine, herbal remedies are proved to exert their effectiveness at different stages of stone pathophysiology, the plant based therapy is used as addition therapy for better relief. Supplementary research is needed to identify active principles from medicinal plants to evaluate their dosage and quality control, and investigate their interactions and adverse effects. Many herbs themselves possess inhibitory activity against crystallization. According to literature survey Kidney stone formation has been found to those people who were not taken food timely or irregular life style. The anti oxidant activity of the herbs also help in preventing the urolithiatic renal cell damage. Although use of herbal medicine is popular from traditional periods because of their potent activity and safety, it is of great importance to carry out further research to understand the pathophisiology of disease, mechanism of action of herbal medicines inorder to develop an efficient and safe litholytic agent.

 

Acknowledgement

Authors are thankful to Dr. C.P. Jain for providing all the facilities Department of Pharmaceutical Sciences, Professor of Mohanlal Sukhadia University Udaipur 313001 Rajasthan India for his gracious support during the work.

 

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