Phyllanthus niruri normalizes elevated urinary calcium levels in calcium stone forming (CSF) patients

Abstract

Phyllanthus niruri is a plant used for years in Brazil to treat urinary calculi. We prospectively evaluated the effect of P. niruri intake on 24 h urinary biochemical parameters in an attempt to assess its in vivo effect in calcium stone forming (CSF) patients. A total of 69 CSF patients (39 males and 30 females, 38+/-8 years old) were randomized to take either P. niruri ( n=33) (450 mg capsules, td) or placebo ( n=36) for 3 months. Blood calcium, uric acid, citrate, magnesium, oxalate, sodium and potassium were determined at baseline and at the end of the study. A subset analysis was made in patients classified according to the presence of metabolic abnormalities (hypercalciuria, hyperuricosuria, hyperoxaluria, hypocitraturia and hypomagnesiuria). Overall, there were no significant differences in the mean values of urinary parameters between the urine samples before and after P. niruri intake, except for a slight reduction in mean urinary magnesium after P. niruri, which was within the normal range. However, in the subset analysis, we observed that P. niruri induced a significant reduction in the mean urinary calcium in hypercalciuric patients (4.8+/-1.0 vs 3.4+/-1.1 mg/kg/24 h, P<0.05). In this short-term follow-up, no significant differences in calculi voiding and/or pain relief between the groups taking P. niruri or the placebo were detected. Our data suggest that P. niruri intake reduces urinary calcium based on the analysis of a subset of patients presenting with hypercalciuria. Larger trials including primary hypercalciuric stone formers should be performed in order to confirm these findings and to determine the possible clinical consequences of urinary calcium reduction during P. niruri administration.

Evaluation of (anti)genotoxic activities of Phyllanthus niruri L. in rat bone marrow using the micronucleus test

“…Extracts of P. niruri were found to normalize high levels of urinary calcium, reducing the formation of calculus in patients (Nishiura et al, 2004). This suggests it interferes in the first stages of stone formation and may be an alternative in the treatment and/or prevention of urolithiasis and inhibit the formation of calcium oxalate crystals in the urinary tract, preventing renal calculus (Barros et al, 2003; Freitas, Schoe, Boim, 2002).…”

Phytochemicals from Phyllanthus niruri Linn. and their pharmacological properties: a review

“…A Brazilian research group reported that intake of P. niruri reduces urinary calcium, based on the analysis of a subset of patients presenting with hypercalciuria (Nishiura et al 2004). An inhibitory effect of P. niruri extract on CaOx crystal growth and aggregation in human urine suggested that it might interfere with the early stages of stone formation and represent an alternative form of prevention for urolithiasis (Barros et al 2003).…”

Plantas medicinais no controle de urolitíase

“…Estes pacientes apresentaram 38 ± 8 anos de idade, sendo 39 do sexo masculino e 30 do feminino. Os cálculos renais foram diadnosticados por ultrasonografia renal e raios-X abdominal (Nishiura et al, 2004). Observou-se o controle da hipercalciúria e leve redução de magnésio na urina, mas a quantidade e tamanho dos cálculos não sofreram qualquer alteração, bem como os parâmetros urinários.…”