Main Article Content
Abstract
Urolithiasis, a prevalent and painful condition, involves the formation of stones in the kidneys or urinary tract, predominantly composed of calcium oxalate. Despite extensive research, effective non-invasive treatments remain limited. This study explores the antiurolithiatic potential of Moringa oleifera leaf stalk extract through in vitro models. The extract was evaluated for its ability to dissolve calcium oxalate and calcium phosphate stones, as well as its efficacy in inhibiting nucleation and aggregation of these crystals. In the dissolution study, Moringa oleifera extract showed a significant dissolution of both calcium oxalate (46.45%) and calcium phosphate (48.33%) stones, compared to the standard drug Cystone, which exhibited higher dissolution rates of 54.67% and 74.16%, respectively. Nucleation assays confirmed the extract's ability to prevent initial crystal formation, with higher concentrations showing increased efficacy. Aggregation assays demonstrated that the extract effectively inhibited the clustering of calcium oxalate crystals, reducing the potential for stone growth and renal injury. Phytochemical analysis identified alkaloids, flavonoids, terpenoids, glycosides, and saponins in the Moringa oleifera extract, which may contribute to its antiurolithiatic properties. The results indicate that Moringa oleifera leaf stalk extract can significantly inhibit stone formation and promote dissolution, offering a promising natural alternative for the prevention and treatment of urolithiasis. Further pharmacological and clinical studies are needed to fully understand the mechanisms and efficacy of this herbal remedy in managing kidney stones.
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References
- 1. Ghelani, Hardik, Maunik Chapala, and Pinakin Jadav. "Diuretic and antiurolithiatic activities of an ethanolic extract of Acorus calamus L. rhizome in experimental animal models." Journal of traditional and complementary medicine. 2016; 6(4): 431-436.
- https://www.sciencedirect.com/science/article/pii/S2225411015001200
- 2. Mitra, S. K., et al. "Effect of cystone, a herbal formulation, on glycolic acid‐induced urolithiasis in rats." Phytotherapy Research: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives. 1998; 12(5): 372-74.
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- 4. Sakhaee, Khashayar, Naim M. Maalouf, and Bridget Sinnott. Kidney stones 2012: pathogenesis, diagnosis, and management. The Journal of Clinical Endocrinology & Metabolism. 2012; 97(6):1847-60.
- 5. Aggarwal KP, Narula S, Kakkar M. Molecular mechanism of renal stone. Biomed Research International. 2013.
- 6. McNutt WF .Chapter vii: Vesical calculi (cysto-lithiasis). Diseases of the Kidneys and Bladder. A Text-book for students of medicine. iv. Diseaeses of the the bladder. Philadelphia: JB Lippincott company. 1893; pp.185-6
- 7. Türk C, Knoll T, Petrik A, Sarica K, Straub M, Seitz C. Guidelines on urolithiasis. European association of urology. 2011 Mar 30.
- 8. De Mais, Daniel. ASCP Quick compendium of clinical pathology. 2nd ed. Chicago ASCP Press. 2009.
- 9. Abbagani S, Gundimeda SD, Varre S, Ponnala D, Mundluru HP. Kidney stone disease: Etiology and evaluation. 2010.
- 10. Coe, FL; Evan, A; Worcester E. Kidney stone disease. The Journal of Clinical investigation. 2005;115(10): 2598-608.
- 11. Miller, NL; Lingeman JE. Management of kidney stones. BMJ. 2007; 334(7594): 468-72.
- 12. Anita Saxena and R.K.Sharma. Nutritional aspects of nephrolithiasis. Indian Journal of Urology. 2010; 26(4):523-530.
- 13. Gilani AH, Rahman AU. Trends in Ethnopharmacology. Journal of ethnopharmacology. 2005.
- 14. Butterweck V, Khan SR. Herbal medicines in the management of urolithiasis: Alternative or complementary. Planta Med. 2009; 75:1095-1103.
- 15. Usha Vanamala UV etal., An updated review on diuretic plants. 2012. Pp29-30.
- 16. Kumar BNS, Swami BMV, Swami A, et.al., A Review on natural diuretics.Research Journal of pharmaceutical, biological and chemical sciences. 2010; 1(4): 615-634.
- 17. Sharma V, Verma P. Convolvulus arvensis-L. root extracts increase urine output and electrolytes in rats. International journal of pharmaceutical research and development. 2011;3(3): 193-197.
- 18. Chopra RN, Nayar SL, Chopra IC. Glossary of Indian medicinal plants (including the supplement), Council Sci. Ind. Res., New Delhi, India. 1986.
- 19. Wright C J et al., Herbal medicines as diuretics, A review of the scientific evidence. Journal of Ethnopharmacology. 2007; 114(1):1-31.
- 20. Anwar F, Latif S, Ashraf M, Gilani AH. Moringa oleifera: A food plant with multiple medicinal uses. Phytother res. 2007; 21:17-25.
- 21. Rohith Singh Tahkur, Geeta Soren, Rama Mohan Pathapati, Madhavulu Buchineni. Diuretic activity of Moringa oleifera leaves extract in swiss albino rats. The pharma innovation Journal. 2016;5(3): 08-10.
- 22. Atodariya U, Barad R, Upadhyay S, Upadhyay U. Anti-urolithiatic activity of Dolichos biflorus seeds. Journal of Pharmacognosy and Phytochemistry. 2013;2(2):209-13.
- 23. Phatak RS, Hendre AS. In-vitro antiurolithiatic activity of Kalanchoe pinnata extract. International Journal of Pharmacognosy and Phytochemical Research. 2015;7(2):275-9.
- 24. Thermadum Vareed Binu, Bhavaniamma Vijayakumari. In-vitro antiurolithiatic activity of Strychnos potatorum L.F. South Indian Journal of Biological Sciences. 2016; 2(1):174-178.
References
1. Ghelani, Hardik, Maunik Chapala, and Pinakin Jadav. "Diuretic and antiurolithiatic activities of an ethanolic extract of Acorus calamus L. rhizome in experimental animal models." Journal of traditional and complementary medicine. 2016; 6(4): 431-436.
https://www.sciencedirect.com/science/article/pii/S2225411015001200
2. Mitra, S. K., et al. "Effect of cystone, a herbal formulation, on glycolic acid‐induced urolithiasis in rats." Phytotherapy Research: An International Journal Devoted to Pharmacological and Toxicological Evaluation of Natural Product Derivatives. 1998; 12(5): 372-74.
3. Worcester EM, Coe FL. Nephrolithiasis. Prim Care. 2008 Jun;35(2):369-91. doi: 10.1016/j.pop.2008.01.005. PMID: 18486720; PMCID: PMC2518455.
4. Sakhaee, Khashayar, Naim M. Maalouf, and Bridget Sinnott. Kidney stones 2012: pathogenesis, diagnosis, and management. The Journal of Clinical Endocrinology & Metabolism. 2012; 97(6):1847-60.
5. Aggarwal KP, Narula S, Kakkar M. Molecular mechanism of renal stone. Biomed Research International. 2013.
6. McNutt WF .Chapter vii: Vesical calculi (cysto-lithiasis). Diseases of the Kidneys and Bladder. A Text-book for students of medicine. iv. Diseaeses of the the bladder. Philadelphia: JB Lippincott company. 1893; pp.185-6
7. Türk C, Knoll T, Petrik A, Sarica K, Straub M, Seitz C. Guidelines on urolithiasis. European association of urology. 2011 Mar 30.
8. De Mais, Daniel. ASCP Quick compendium of clinical pathology. 2nd ed. Chicago ASCP Press. 2009.
9. Abbagani S, Gundimeda SD, Varre S, Ponnala D, Mundluru HP. Kidney stone disease: Etiology and evaluation. 2010.
10. Coe, FL; Evan, A; Worcester E. Kidney stone disease. The Journal of Clinical investigation. 2005;115(10): 2598-608.
11. Miller, NL; Lingeman JE. Management of kidney stones. BMJ. 2007; 334(7594): 468-72.
12. Anita Saxena and R.K.Sharma. Nutritional aspects of nephrolithiasis. Indian Journal of Urology. 2010; 26(4):523-530.
13. Gilani AH, Rahman AU. Trends in Ethnopharmacology. Journal of ethnopharmacology. 2005.
14. Butterweck V, Khan SR. Herbal medicines in the management of urolithiasis: Alternative or complementary. Planta Med. 2009; 75:1095-1103.
15. Usha Vanamala UV etal., An updated review on diuretic plants. 2012. Pp29-30.
16. Kumar BNS, Swami BMV, Swami A, et.al., A Review on natural diuretics.Research Journal of pharmaceutical, biological and chemical sciences. 2010; 1(4): 615-634.
17. Sharma V, Verma P. Convolvulus arvensis-L. root extracts increase urine output and electrolytes in rats. International journal of pharmaceutical research and development. 2011;3(3): 193-197.
18. Chopra RN, Nayar SL, Chopra IC. Glossary of Indian medicinal plants (including the supplement), Council Sci. Ind. Res., New Delhi, India. 1986.
19. Wright C J et al., Herbal medicines as diuretics, A review of the scientific evidence. Journal of Ethnopharmacology. 2007; 114(1):1-31.
20. Anwar F, Latif S, Ashraf M, Gilani AH. Moringa oleifera: A food plant with multiple medicinal uses. Phytother res. 2007; 21:17-25.
21. Rohith Singh Tahkur, Geeta Soren, Rama Mohan Pathapati, Madhavulu Buchineni. Diuretic activity of Moringa oleifera leaves extract in swiss albino rats. The pharma innovation Journal. 2016;5(3): 08-10.
22. Atodariya U, Barad R, Upadhyay S, Upadhyay U. Anti-urolithiatic activity of Dolichos biflorus seeds. Journal of Pharmacognosy and Phytochemistry. 2013;2(2):209-13.
23. Phatak RS, Hendre AS. In-vitro antiurolithiatic activity of Kalanchoe pinnata extract. International Journal of Pharmacognosy and Phytochemical Research. 2015;7(2):275-9.
24. Thermadum Vareed Binu, Bhavaniamma Vijayakumari. In-vitro antiurolithiatic activity of Strychnos potatorum L.F. South Indian Journal of Biological Sciences. 2016; 2(1):174-178.