Anti-Urolithiatic Effect of Cow Urine Ark on Ethylene Glycol-Induced Renal Calculi

Purpose To investigate the anti-urolithiatic effect of cow urine ark (medicinal distilled cow urine) on ethylene glycol (EG) induced renal calculi. Materials and Methods 36 male Wistar rats were randomly divided into 6 equal groups. Group I animals served as vehicle control and received distilled water for 28 days. Group II to VI animals received 1% v/v EG in distilled water for 28 days. Group II served as EG control. Group III and IV (preventive groups) received cow urine ark orally for 28 days in doses of 1 mL/kg and 2 mL/kg, respectively. Group V and VI (treatment groups) received 1 mL/kg and 2 mL/kg cow urine ark orally, respectively from 15th to 28th days. 24-hour urine samples were collected on day 0 and 28. Urine volume and oxalate levels were measured. On day 28, blood was collected for biochemical parameters. Animals were sacrificed and kidneys were harvested, weighed and histopathologically evaluated for calcium oxalate (CaOx) crystals. To calculate the percentage of inhibition of mineralization, simultaneous flow static in-vitro model was used. Results EG significantly increased urine oxalate, serum creatinine, blood urea level; kidney weight and CaOx deposits. Provision of cow urine ark resulted in significantly lower levels of urine oxalate, serum creatinine, blood urea and CaOx depositions as compared to Group II. (p value < 0.05) It also significantly restored kidney weight. (p value < 0.05) Cow urine ark inhibited 40% and 35% crystallization of CaOx and calcium phosphate, respectively. Conclusion Cow urine ark is effective in prevention and treatment of EG induced urolithiasis in Wistar rats. .

Cytoprotective role of the aqueous extract of Terminalia chebula on renal epithelial cells

PURPOSE: Kidney stone is one of the most prevalent diseases worldwide. Calcium oxalate (CaOx) has been shown to be the main component of the majority of stones formed in the urinary system of the patients with urolithiasis. The present study evaluates the antilithiatic properties of Terminalia chebula commonly called as "harad" which is often used in ayurveda to treat various urinary diseases including kidney stones. MATERIALS AND METHODS: The antilithiatic activity of Terminalia chebula was investigated on nucleation and growth of the calcium oxalate crystals. The protective potency of the plant extract was also tested on oxalate induced cell injury of both NRK-52E and MDCK renal epithelial cells. RESULTS: The percentage inhibition of CaOx nucleation was found 95.84% at 25µg/mL of Terminalia chebula aqueous extract which remained almost constant with the increasing concentration of the plant extract; however, plant extract inhibited CaOx crystal growth in a dose dependent pattern. When MDCK and NRK-52E cells were injured by exposure to oxalate for 48 hours, the aqueous extract prevented the injury in a dose-dependent manner. On treatment with the different concentrations of the plant extract, the cell viability increased and lactate dehydrogenase release decreased in a concentration dependent manner. CONCLUSION: Our study indicates that Terminalia chebula is a potential candidate for phytotherapy against urolithiasis as it not only has a potential to inhibit nucleation and the growth of the CaOx crystals but also has a cytoprotective role.

Antihyperuricemic and diuretic effects of procyanidins extracted from Crataegus monogyna

Data indicated that procyanidins extracted from grape seeds has uric acid lowering effects in mice, however the hypouricaemic effect of procyanidins was accompanied with changes in enzymatic activities of xanthine dehydrogenase and xanthine oxidase. This study was designed to investigate the effect of procyanidins extracted from Crataegus monogyna on serum uric acid, adenosine deaminase [ADA], 5-nucleotidase, xanthine oxidase, and renal function on normal and potassium oxonate induced hyperuricemic rats. Thirty female albino rats were divided into three groups. The first group included 18 rats pretreated with the uricase inhibitor potassium oxonate [250 mg/kg, i.p.], served as an animal model for hyperuricemia. The rat models were divided into three subgroups, each subgroup having six rats. The first subgroup served as a normal control. Subgroup 2 received a single daily dose [100 mg/kg p.o] of procyanidins for 7 days. The third subgroup received daily dose [50 mg/kg p.o] of allopurinol for 7 days as positive control. The second group included six rats received only water as a vehicle. The serum uric acid, xanthine oxidase, adenosine deaminase [ADA] and 5-nucleotidase levels were measured and com-pared to those in normal untreated control group. The Third group included six normal rats received a single dose of Procyanidins [50 mg/kg body weight; i.v.] to study the renal ef-fects of procyanidins.. A single daily dose [100 mg/kg PO] of procyanidins for 7 days significantly reduced serum levels of uric acid, ADA and 5'-nucleotidase, without detectable effects on the level of xanthine oxidase in hyperuricemic rats. Intravenous infusion of a single dose of procyanidins [50 mg/kg i.v] produced marked increases in urinary Na+excretion [4.8 folds] and urine flow [2.6 folds] accompanied by insignificant change of potassium excretion in the rats. The reduction in serum uric acid most probably is due to inhibiting enzymes, ADA and 5-nucleotidase. The antihyperuricemic and diuretic effects of procyanidins recommended it as a good drug for the treatment of gout and renal uric acid calculi

Antilithiatic effect of grains of Eleusine coracana

The effect of aqueous and alcohol extracts of Eleusine coracana Linn. [Poaceae] on calcium oxalate nephrolithiasis has been studied in male albino rats. Ethylene glycol feeding resulted in hyperoxaluria as well as increased renal excretion of calcium and phosphate. Supplementation with aqueous and alcohol extracts of E. coracona grains [300 mg/kg b.w., p.o.] significantly reduced the elevated urinary oxalate, showing a regulatory action on endogenous oxalate synthesis. The increased deposition of stone forming constituents in the kidneys of calculogenic rats was significantly lowered by curative and preventive treatment using aqueous and alcohol extracts. From this study, we conclude that both the prophylactic and therapeutic treatment with aqueous and alcohol extracts of grains of E. coracana had an inhibitory effect on crystal growth, with improvement of kidney function as well as cytoprotective effect

Effect of Rowatinex on calculus clearance after extracorporeal shock wave lithotripsy

Our aim was to evaluate the effect of Rowatinex, an essential oil preparation of terpenic type, on kidney calculi clearance after extracorporeal shock wave lithotripsy [SWL]. A randomized controlled trial was performed at Hormozgan Hospital in Bandar Abbas, Iran, on 100 patients with 10-mm to 20-mm kidney calculi. They underwent SWL, and then, they were randomly assigned into 2 groups to receive Rowatinex, 100 mg, 3 times per day, or placebo after SWL. The patients were followed up with plain abdominal radiography, ultrasonography, and excretory urography [if required], 2 and 4 weeks postoperatively. Two weeks following SWL, 6 [12%] and 9 [18%] patients in the Rowatinex and control groups had fragmented calculi without clearance, 26 [52%] and 24 [48%] had less than 50% clearance, 9 [18%] and 15 [30%] had more than 50% but not total clearance, and 9 [18%] and 2 [4%] patients were stone free, respectively. Rowatinex had a significant effect on the stone-free rate [P=.02]. Four weeks post-SWL, 3 [7.3%] and 7 [14.6%] other patients in the Rowatinex and control groups became stone free, respectively. Overall, Rowatinex had no significant effect on the stone-free rate [P=.46]. No complications or differences between the two groups in symptoms and sign we reported. Rowatinex does not have a significant effect on clearance rate of kidney calculi after SWL. However, it can accelerate calculus passage after 2 weeks, and it does not have any significant adverse effects

[ preventive effects of ethyl acetate fractions from aqueous and ethanolic extract of Nigella sativa L. seeds on calcium oxalate stones in Wistar rat]

Various pharmacological effects of Nigella sativa including; anti-inflammatory and antimicrobial effects, disruption of kidney stone, lowering serum lipids and repairment of kidney tissues after nephrotoxicity, have been reported. The aim of this study was to investigate the preventive action of ethyl acetate fractions of aqueous-ethanolic extract of Nigella sativa seeds on calcium oxalate kidney stones in male rats. 31 male Wistar rats were randomly divided into four groups. All groups were studied during 28 days of experimental protocol. Healthy control group [1] received tap drinking water. Negative control group [2] received 1% ethylene glycol in drinking water. Groups 3 and 4 were treated with 1% ethylene glycol as well as ethyl acetate phase remnant and ethyl acetate fractions from aqueous and ethanolic extract of Nigella sativa L. seeds, respectively at equivalent dose of 250 mg/kg of total extract. Urine concentration of oxalate, citrate and calcium in days 0, 14 and 28, and also plasma concentration of magnesium and calcium in days 0 and 28, were measured. At the end of experiment, kidneys were removed for histopathologic study and examined for counting calcium oxalate deposits. Data were presented as Mean +/- SEM and were analyzed by one way ANOVA and subsequently Tukey tests; p value less than 0.05 [p<0.05] was considered significant. Results showed that the number of calcium oxalate crystals in group 2 vs. group 1 and 3 [without any crystals] significantly increased [p<0.001], but there was no significant difference between groups 2 and 4. Urine oxalate concentration in day 28 increased significantly in groups 2, 3 and 4 [p<0.05] in comparison with day 0, but urine calcium concentration in groups 3 and 4 at day 28 has no significant difference with day 0. The results of this study supported the inhibitory action of aqueous-ethanolic extract of Nigella sativa ethyl-acetate phase remnant on calcium oxalate kidney stones. However, ethyl acetate fraction of extract did not show a similar effect on kidney stones. Although the exact mechanism is not clear, but this action may be due to antioxidant, antilipid or anti-inflammatory properties of Nigella sativa seed. Therefore, Nigella sativa should be advised in treatment of human kidney stone disease

[ effects of ethanolic extract of Nigella Sativa seeds on ethylene glycol induced kidney stones in rat]

The incidence of urinary stones is very high in population. Treatment of patients with kidney stones in primary stages can reduce the side effects and also may prevent the surgical operations and postoperative complications. Several effects have been reported for Nigella sativa seeds; they include: anti analgesic, anti inflammatory, lowering serum lipids, increasing glutathione in kidney and repairement of kidney tissues after nephrotoxicity. The aim of this study was to investigation the effects of the ethanolic extract of N. Sativa seeds on kidney stones in rat. Thirty two Wistar rats weighed 200_10g were randomly divided into 4 groups: Group an as intact control was received tap drinking water for thirty days. Group B [ethylene glycol control], groups C and D as experimental animals all were received 1% [v/v] ethylen glycol in drinking water for 30 days. Furthermore group C was also treated with 250 mg/kg B.W N. sativa ethanolic extract for 30 days, while group D was also treated with 250mg/kg B.W N. sativa extract from 14th day through the end of the experiment. Twenty four hour urine samples were collected on the 0,7th, 14th and 30th days of the study, when each animal was kept in a metabolic cage. After 30 days all rats were killed by guillotine and kidneys were removed and sections were prepared with routine histological techniques; slides were examined under light microscope to count calcium oxalate deposits. The results showed that the number of calcium oxalate deposits were significantly increased in group B vs. A [p<0.001]. The number of deposits in group C and D were significantly less than group B [p< 0.05]; while the number of calcium oxalate deposits in group C and D in comparison with group A were statistically insignificant. The calcium oxalate concentration in urine at the end of the study was increased significantly in group B vs. A [p<0.001] but decreased in group C [p<0.001] and D [p<0.05] when compared with group B. The result of this study demonstrated that treatment of rats with ethanolic extract of N. sativa has reduced the number of calcium oxalate deposits in both groups of treated animals. Therefore; it may have beneficial effects in treatment of urinary stones in patients

The effects of potassium and magnesium supplementations on urinary risk factors of renal stone patients.

The effects of potassium and magnesium supplementation on urinary risk factors for renal stone disease were studied in 61 renal stone patients. The subjects were divided into four groups and supplemented for a period of one month with potassium chloride (KCl, Group 1), potassium sodium citrate (K Na citrate, Group 2), magnesium glycine (Mg glycine, Group 3) and potassium magnesium citrate (K Mg citrate, Group 4) with a daily dose of 42 mEq potassium, 21 mEq magnesium or sodium and 63 mEq citrate, accordingly. The results showed that serum potassium and magnesium of all four groups normalized after the supplementation. Though urinary potassium significantly increased in all three groups supplemented with elemental potassium containing solutions [i.e. KCl (p < 0.001), K Na citrate (p < 0.001) and K Mg citrate (p < 0.001)] only K Na citrate and K Mg citrate, caused a significant increase in urinary pH and citrate but decrease in calcium. Supplementation with Mg glycine in Group 3 although caused a significant increase in urinary magnesium, its effects on urinary pH, citrate and calcium, however, were similar to KCl, in that they caused a significant decrease in urinary pH without any change in urinary citrate or calcium. Supplementation with K Mg citrate in Group 4 seems to have given the best results, as far as lowering stone risk factors in that it caused an increase in urinary pH, potassium and citrate and decreased calcium excretions similar to K Na citrate in Group 2. In addition, K Mg citrate also caused the enrichment of urine with magnesium, another inhibitor of calcium-containing stones. Although the four supplements had no effect on urinary saturation of calcium oxalate salt, their effects on the saturations of brushite (CaHPO4 x 2H2O), octacalcium phosphate (Ca8H2 (PO4)6 x 5H2O) and uric acid were clearly associated with changes in urinary pH. Therefore, in Group 1 and 3, subjects having a decrease in urinary pH, also experienced a significant increase in uric acid saturation. Though the saturation of brushite and octacalcium phosphate in Group 2 and 4 and the sodium acid urate in Group 2 were significantly increased, these urinary risk factors could be overcome, however, by the concomitant increase in urinary citrate. The present results demonstrate that for those stone vulnerable subjects having a high risk of potassium and magnesium depletion, to obtain the best therapeutic results, they should be provided supplementations of both potassium and magnesium together and also in the forms that would result in the delivery of an alkali loading effect.

A long-term study on the efficacy of a herbal plant, Orthosiphon grandiflorus, and sodium potassium citrate in renal calculi treatment.

The study was performed to compare the efficacy of a herbal plant, Orthosiphon grandiflorus (OG), and the drug sodium potassium citrate (SPC) in treatment of renal calculi. Forty-eight rural stone formers identified by ultrasonography were recruited and randomly assigned to two treatment groups (G1 and G2). For a period up to 18 months, subjects in G1 received 2 cups of OG tea daily, each tea cup made from an OG tea bag (contained 2.5 g dry wt), and G2 received 5-10 g of granular SPC in solution divided into three times a day. Once every 5 to 7 weeks, subjects were interviewed, given an additional drug supply, administered a kidney ultrasound and had spot urine samples collected for relevant biochemical analysis. From the recorded ultrasound images, rates of stone size reduction per year (ROSRPY) were calculated. The mean ROSRPY was 28.6+/-16.0% and 33.8+/-23.6% for G1 and G2, respectively. These two means were not significantly different. ROSRPY values of G1 and G2 were combined and divided into three levels: Level A (ROSRPY > mean + 0.5 SD), Level M (ROSRPY = mean +/- 0.5 SD) and Level B (ROSRPY < mean - 0.5 SD). Dissolution of stones was least in Level B which was related to higher excretions of Ca and uric acid in the urine. After treatment, 90% of the initial clinical symptoms (ie back pain, headaches and joint pain) were relieved. Fatigue and loss of appetite were observed in 26.3% of G2 subjects. Our study indicates that treatment of renal calculi with OG tea is an alternative means of management. Further investigation is needed to improve dissolution of stones with a low ROSRPY.

Involução de litíase renal com citrato de potássio e hidroclorotiazida / Clinical treatment of renal lithiasis with potassium citrate and hidroclorotiazide: a case report

Recentemente tem surgido estudos buscando comprovar os efeitos benéficos da terapêutica com citrato de potássio para prevenção e tratamento da litíase renal. Os autores relatam um caso de involução de cálculo renal e revisam a literatura atual sobre a patogenia dos cálculos, tratamentos disponíveis e prevenção de recidivas

Effect of vitamin E and mannitol on renal calcium oxalate retention in experimental nephrolithiasis.

The calcium oxalate stone formation is induced in rats by a single injection of sodium oxalate (i.p., 7 mg/100 g body weight). There was increase in kidney oxalate concentration and kidney mitochondrial oxalate binding activity with increased lipid peroxidation. Histopathological observations showed larger aggregates of calcium oxalate crystals in the renal tubules. At 12 hours after oxalate administration a maximal crystal deposition in the renal tubule with denuded epithelium, lymphocytic infiltration and blood were observed. Increased blood urea and creatinine indicated kidney failure after oxalate administration. Calcium oxalate crystalluria, hematuria, and proteinuria with casts were observed. Renal antioxidants vitamin E, ascorbic acid and glutathione were significantly decreased on oxalate challenge. Pretreatment with vitamin E provided only partial protection from calcium oxalate deposition. Pretreatment with vitamin E and mannitol together protected the renal tubules completely from calcium oxalate deposition by normalizing the tissue oxalate concentration and mitochondrial oxalate binding activity and increasing the concentration of antioxidants on oxalate challenge.

Pharmacokinetic studies of SHAM capsules

Urinary excretion data of salicylhydroxamic acid [SHAM] on human volunteers were used to compute its pharmacokinetic parameters. HPLC method was used to determine drug content in urine. The study revealed that, the drug is rapidly absorbed and excreted. The absorption half life of the drug ranged between 15.2-23.2 min. While, its urinary elimination t1/2 was in the range of 23.1 to 42.2 min. The amount of the drug eliminated in urine reaches to about 75% of the oral dose administrated proving SHAM efficiency as antilithiatic drug. On the other hand, the drug is hardly detected in urine after 6 hours indicating a thorough revision of dosage regimen

Diclofenac sodium in renal and ureteral colic: a double-blind comparison with hyoscine N-butyl bromide

The analgesic effects of diclofenac 75 mg IM and hyoscine N- buty1 bromide 20 or 40 mg or IV were compared in a randomized double-blind study, in 422 patients reporting moderate to severe pain due to renal or ureteral colic. Patients evaluated their pain intensity and pain relief at 0 [baseline], 15, 30, 45 minutes and hourly for 3 hours. A significant difference [p < 0.05] was found between the two groups with respect to pain intensity difference [PID], mean pain relief and onset time of analgesia. Diclofenac sodium was significantly [p < 0.05] superior to hyoscine N buty1 bromide in pain relief. Significantly [p < 0.05] fewer patents required a second dose in diclofenac sodium treated group compared to the other spasmolytic group. The dose and the route of administration of hyoscine N buty1 bromide had no significant [p > 0.05] effect on the proportion of patients with complete relief. These results confirmed that diclofenac sodium can be safely used in the management of acute renal and ureteral colic as an alternative to hyoscine N buty1 bromide

Efeitos do fenobarbital em pacientes com nefrolitíase de cálcio / Phenobarbital effects in patients with calcium nephrolithiasis

Os autores apresentam os resultados de um estudo realizado em 20 pacientes com nefrolitíase cálcica tratados com fenobarbital, 100mg/dia, durante 32 dias. O tratamento com o fenobarbital reduziu a calcemia (9,21 ñ 0,57mg/dl vs. 8,30 ñ 1,07mg/dl; p < 0,05), a calciúria (185,4 ñ 74,91mg/24h vs. 132,8 ñ 50,12mg/24h; p < 0,001), a uricosúria (785,27mg/24h vs. 551,8 ñ 215,02mg/24h; p < 0,05) e a FEAU (12,07 ñ 5,95// vs. 8,33 ñ 3,00//; p < 0,05) e elevou a RTP (82,45 ñ 6,20// vs. 89,11 ñ 4,11//; p < 0,01). O TSCa näo sofreu alteraçöes. Visto que o fenobarbital é uma droga segura, cujos efeitos nos parâmetros hematológicos, hepáticos e renais säo despreziveis, e a ocorrência de doença óssea desmineralizante é rara, os autores consideram que o medicamento deva ser objeto de investigaçäo no tratamento da litíase cálcica, principalmente quando a hipercalciúria e/ou a hiperuricosúria estiverem associadas

Nitrilotriacetate therapy of alkaline earth urinary calculi

Los mecanismos por los cuales la administración oral de nitrilotriacetato (NTA) previene y disuelve cálculos urinarios compuestos por brushita, CaH804 . 2HZ0 y struvita, MgNH4PO4 . 6 H2O, han sido estudiados en ratas por administración intravenosa del quelato a dosis bajas, 14 micronmol/kg, intermedias, 41 micronmol/kg y la dosis máxima tolerada de 82 micronmol/kg. Con todas las dosis se observó una rápida fosfaturia. El Ca y NTA urinario variaron con la dosis y el tiempo. En la primera hora posinyección, para todas las dosis de NTA, el calcio urinario presentó valores mayores o iguales que el control. En la segunda hora la excreción fue igual o más baja que los controles y fue uniformemente bajo en la tercera hora. La variable excreción de NTA y calcio tuvo una relación máxima NTA/Ca = 5,9 en la segunda hora después de la administración de 82 micronmol/kg. Los datos sugieren que el NTA en plasma establece un buffer de calcio hipocalcémico, el cual provoca un estímulo para la secreción de PTH. El aumento resultante de la reabsorción renal de Ca y CaNTA, a partir del filtrado glomerular, establece la relación variable NTA/Ca en orina. Los límites del proceso están establecidos por la hipocalcemia relacionada a la dosis de NTA, la máxima capacidad de reabsorción del Ca por el riñón y la solubilidad del CaNTA en orina. Además de la potencial utilidad terapéutica, la inusual capacidad del NTA para imponer una sobrecarga de calcio al riñón, simultáneamente con hipocalcemia, sugiere su utilización como una prueba funcional paratiroidea y renal en el metabolismo del calcio

Cálculo coraliforme com hiperexcreçäo de ácido úrico: tratamento clínico / Staghorn calculi with hyperexcretion of uric acid: clinical treatment

Os autores relatam dois casos de dissoluçäo de cálculos coraliformes através de alcalinizaçäo da urina e fazem breve revisäo sobre aspectos teóricos e clínicos no tratamento de litíase úrica