Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention

Phyllanthus niruri (P.niruri) or stone breaker is a plant commonly used to reduce stone risk, however, clinical studies on this issue are lacking.

To prospectively evaluate the effect of P. niruri on the urinary metabolic parameters of patients with urinary lithiasis.

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%.

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).

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.

International braz j urol : official journal of the Brazilian Society of Urology. 2018 Mar 10 [Epub ahead of print]

Nidia D Pucci, Giovanni S Marchini, Eduardo Mazzucchi, Sabrina T Reis, Miguel Srougi, Denise Evazian, William C Nahas

Divisão de Nutrição e Dietética, Instituto Central, Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina. São Paulo, Brasil., Divisão de Urologia, Hospital das Clínicas, Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil., Laboratório de Investigação Médica, Universidade de São Paulo, Faculdade de Medicina, São Paulo, Brasil.