Preliminary investigation on ultra high diluted B. vulgaris in experimental urolithiasis.

PURPOSE: The study focuses on the anti-urolithiasis potential of ultra-diluted homeopathic potency of Berberis vulgaris (B. vulgaris) root bark, commonly used in homeopathic system to treat renal calculi. METHODOLOGY: B. vulgaris root bark (200c, 20 µl/100 g body weight/day, p.o, for 28 days) was tested in an animal model of urolithiasis. Urolithiasis was induced in male Wistar rats by adding 0.75% ethylene glycol (EG) to drinking water. Urine and serum samples were analyzed for calcium, magnesium, phosphorus, uric acid and creatinine. Enzymic makers of renal damage (alkaline phosphatase, lactate dehydrogenase, leucine aminopeptidase and γ-glutamyl transpeptidase) were assessed in kidney and urine. Renal tissues were analyzed for oxalate content. RESULTS: Administration of EG to rats increased the levels of the stone-forming constituents calcium, phosphorus and uric acid, in urine. Levels were normalized by B. vulgaris treatment. The decrease in the urolithiasis inhibitor magnesium in urine was prevented by treatment with B. vulgaris. Serum creatinine levels were largely normalized by B. vulgaris treatment. Hyperoxaluria induced renal damage was evident from the decreased activities of tissue marker enzymes and an apparent escalation in their activity in the urine in control animals; this was prevented by B. vulgaris treatment. CONCLUSION: Homeopathic B. vulgaris root bark has strong anti-urolithiasis potential at ultra-diluted dose.

Effect of blind treatment on stone disease.

Most of the drugs administered to stone patients appear to be inappropriate and doing more harm than good to the patients. The objective of this paper is to identify the prevalence of blind chemotherapy among the stone patients and find out the real indication for the drugs administered. Patients who attended the stone clinic for the first time were interviewed to find out what drugs they had been taking before the attendance at the stone clinic. 350 patients consuming specific drugs relevant to stone formation at least for a period of 15 days were selected for a detailed assessment. The type of drug consumed, the dose, the duration, the side effects, compliance rate and effect on stone disease were assessed. The biochemical profile of the patients was assessed to identify the role of the therapeutic modalities utilised. Conclusions regarding the utility of drugs in the process of stone formation were made. The values were compared with those of patients not on medication and considering laboratory standards. Of the 350 patients studied, 96 patients were consuming potassium citrate in different doses, 50 were consuming allopurinol, 44 cystone, 27 potassium citrate + magnesium, 25 calcury, 24 rowatinex, 21 ayurvedic drugs, 17 dystone, 17 homeopathic medicines and 17 other drugs. The longest duration of compliance was for cystone-2.5 years. All other drugs were stopped by the patients themselves due to recurrence of symptoms. As much as 93% of the patients did not feel that there was any significant relief of symptoms. The side effects which prompted the patients to stop medicine were gastro intestinal upset, particularly with potassium citrate, rowatinex and potassium citrate + magnesium combination. The relevant biochemical changes noted were increased urinary citrate levels in patients consuming potassium citrate alone or in combination with magnesium. Serum uric acid was within normal limits in patients consuming allopurinol. Urine uric acid levels were also lower in patients on allopurinol. It is concluded that most of the drugs administered blindly were neither indicated nor beneficial for the patients. Metabolic correction has to be based on proper metabolic assessment.

Cantharis dissolves calculus in the ureter of a kitten: case repor

Urolithiasis is a disease thatcan occur alone or together, obstruct the urinary flow, and even progress to the animal's death. Objective:The present study is to report the dissolution of calculus in the ureter in a kitten. Methodology: a feline, SRD, male, started at 3 months old with the signs of vomiting, constipation,and hematuria, presenting leukocytosis and increased serum urea. Two abdominal ultrasounds were performed 30 days apart and the third at 3 months. Results:Inthe first ultrasound there was hydronephrosis in the right kidney and dilation of the ureter and microlithiasis in the urinary bladder. The animalhad already been treated with antibiotic therapy and did not improve. Given these characteristics, Cantharis Vesicatoria30cH was administered, there was no more hematuria and when the drug was discontinued, the symptom returned. After 30 days of startinghomeopathic treatment, we repeated the ultrasound which showed 2 kidney stones, and a urinary bladder with cystitis associated with sandy lithiasis. BerberisVulgaris30cH was then administered for 15 days, after which both drugs were discontinued and theanimal remained asymptomatic. After 3 months the ultrasound was repeated which showed 2 kidney stones, Causticum6cH was inserted for 14 days to dissolvekidney stones, thus preventing the return of the initial symptoms. Conclusion:the treatment was beneficial for the patient, who was asymptomatic after the use of Causticum.Considering the natural history of the disease in cats and the high chance of recurrence of the disease, the recommendation was to monitor the organs through an annual ultrasound examination, in addition to encouraging water intake.

Herbal remedies for urinary stones used in India and China: A review.

ETHANOPHARMACOLOGICAL RELEVANCE: The process of formation or appearance of a urinary stone anywhere in the renal tract is known as urolithiasis. It is a longstanding health problem, known to exist since early age of civilization. Records about symptoms, signs and treatment strategies of urinary stones diseases are found in the several ancient texts of traditional medicines such as Ayurveda, Traditional Chinese Medicine (TCM), Siddha and Unani. In Ayurveda, urolithiasis has been considered as one of the eight most troublesome diseases. Ayurvedic management and cure of urinary stone involves herbal formulas, alkaline liquids and surgical procedures. Whereas, TCM recommends polyherbal drugs, acupuncture and mexibustion for treatment of the urinary stones. Among these therapies, herbal remedies are in practice till today for the treatment and cure urinary stone diseases. MATERIALS AND METHODS: A comprehensive review of the scientific literature about pathophysiology of urinary stones and antiurolithiatic plants was undertaken using the following bibliographic databases: MEDLINE/PubMed, Scopus, Web of Knowledge and Google Scholar. The search was conducted from publications from all years until Dec., 2015 by combination of the search terms and Boolean operators; 'urinary stone' OR 'kidney stone' AND 'plant' OR 'medicine' OR 'antiurolithiatic plants'. Outputs were restricted to those completed studies only published in English. In this review, literatures about plants which are used as diuretic and/or in treatment urinary tract infections have not also been considered. The Plant List and Royal Botanical Garden, Kew databases were used to authenticate botanical names of plants. Books and monographs published in English were used to collect information about historical records of antiurolithiatic plants. RESULTS: Recent pharmacological interventions accredited ancient antiurolithiatic claims to several plants and their formulations. The majority of antiurolithiatic plants were found to either dissolve the stones or inhibit the process of urinary stone formation. Plants such as Phyllanthus niruri L. and Elymus repens (L.) Gould, as well as herbal products including 'Wu-Ling-San' formula, 'Cystone' and 'Herbmed' have been proved their utility as promising antiurolithiatic medicines in the different phases of clinical trials. In addition, some of the isolated phytochemicals such as berberine, lupeol, khelin, visnagin, 7-hydroxy-2',4',5'-trimethoxyisoflavone and 7-hydroxy-4'-methoxyisoflavone were reported to have potent antiurolithiatic activity. CONCLUSION: In ancient medicinal texts, antiurolithiatic potential has been ascribed to several plants and their formulations. Present scientific studies provide scientific evidences for few of these claims however, they are insufficient to establish many of these plants and herbal formulations as therapeutic remedies for the treatment and management of urinary stones. Conversely, findings of pre-clinical and clinical studies about some plants and herbal formulations are promising, which underlines the utility of herbal remedies as alternative medicines for the treatment and management of urinary stones in the future.

Beneficial antioxidative effect of the homeopathic preparation of Berberis vulgaris in alleviating oxidative stress in experimental urolithiasis.

BACKGROUND: Oxidative stress is a major mediator in the pathophysiology of several kidney diseases. The cellular damage is mediated by an alteration in the antioxidant status, which increases the concentration of reactive oxygen species (ROS) in the stationary state (oxidative stress). Therefore, interventions favoring the scavenging and/or depuration of ROS should attenuate or prevent the oxidative stress, thereby safeguarding the kidneys against damage. In this sense, this study attempts to evaluate the extent of oxidative stress in experimental urolithiasis by measuring some parameters of oxidant stress and antioxidant defenses in rat kidneys, before and after Berberis vulgaris homeopathic preparation supplementation, and to assess the role, if any, of homeopathic treatment in mitigating free radical toxicity in kidney stone disease. METHODS: Rat model of urolithiasis was established by administering 0.75% ethylene glycol (EG) in drinking water, and the effects of a homeopathic preparation of B. vulgaris root bark (HPBV) on the renal antioxidative defense system as well as on potent markers of free radical activities were investigated. RESULTS: HPBV brought about an augmentation in the activities of enzymatic antioxidants such as superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase, and glucose-6-phosphate dehydrogenase and improved the nonenzymatic antioxidants, e.g., tocopherol, ascorbic acid, and glutathione. HPBV ameliorated the malondialdehyde and protein carbonyl levels and restored renal thiols almost completely. CONCLUSION: Thus, it is shown that HPBV acts as a renoprotective remedy in alleviating the renal calculi-associated oxidative damage by upregulating the antioxidant status.

Evaluación del efecto antiurolitiásico e influencia en la función renal del extracto seco hidroalcohólico al 70% de Mikania cordifolia (L. f.) Willdenow en litiasis renal inducida en animales de experimentación / Evaluation of the anti-urolithic effect and influence on renal function of 70% hydroalcoholic dry extract of Mikania cordifolia (L. f.) Willdenow in induced kidney stones in experimental animals

La presente investigación tuvo como objetivo evaluar el efecto de tipo antiurolitiásico y la influencia en la función renal del extracto seco hidroalcohólico al 70% de Mikania cordifolia. (L.f.) Wildenow administrado por vía oral en ratas Holtzman previa inducción de litiasis renal por el método de hiperoxaluria (inducida con solución de etilenglicol al 0.75% y cloruro de amonio al 0.5% durante 21 días). Se planteó un estudio cuasi experimental con postprueba únicamente y grupos intactos. Se utilizaron 42 ratas albinas hembras las cuales fueron distribuidas en 6 grupos (n=7): de los cuales un grupo se tomó como testigo negativo y a los otros 5 se les indujo la litiasis renal. Una vez inducida la litiasis se tomó un grupo como testigo positivo y a los otros 4 se les administraron tratamiento con el extracto de la planta en estudio, a las dosis de 300 y 500 mg/ kg de peso, ambas durante 14 días y 21 días. Concluido el tiempo de tratamiento, se obtuvieron las muestras de sangre, orina y tejido renal. Se midieron los siguientes indicadores: flujo urinario, creatinina en suero y orina, sodio y potasio en suero y orina, pH en orina, acido oxálico en orina y se realizó el estudio histológico del tejido renal. El análisis de resultados indicó que el tratamiento con el extracto de la planta en estudio a las dosis de 300 mg/Kg durante 21 días y 500 mg/Kg durante 14 y 21 días, incrementan el flujo urinario en un 75%, 77.78% y 66.69% respectivamente; y la depuración de creatinina en un 50.93%, 52.03% y 54.16% respectivamente, de forma significativa respecto al grupo testigo positivo; así mismo disminuye Jos niveles de ácido oxálico en orina en un 48%, 80% y 66.1 %(a las dosis de 300 mg/Kg durante 21 días y 500 mg/Kg durante 14 y 21 días respectivamente) de forma significativa respecto al grupo testigo positivo. Los resultados del análisis histopatológico indican que a las dosis de 300 mg/Kg durante 21 días y 500 mg/Kg durante 14 días, la presencia de microcristales es escasa, mientras que a la dosis de 500 mg/Kg de peso durante 21 no se evidencia presencia de microcristales en el tejido renal. Se concluye que el extracto seco hidroalcohólico preparado de los tallos y hojas de Mikania cordifolia. (L.f.) Willdenow. Presenta efecto antiurolitiasico y mejora la función renal a la dosis de 500 mg/kg de peso desde los 14 días de tratamiento y a la dosis de 300 mg/kg a los 21 días de tratamiento.

Nefrolitiasis: fisiopatología, evaluación metabólica y manejo terapéutico / Nephrolithiasis: pathofisiology, metabolic evaluation, and therapy

La nefrolitiasis es un trastorno frecuente en países desarrollados y en desarrollo. Su prevalencia varía entre el 4 y 20% según diferentes series y depende de la edad de la población analizada, las condiciones geográficas y socioeconómicas del grupo en estudio. La prevalencia de litiasis renal aumenta con la edad tanto en varones como en mujeres; es más común en varones jóvenes. Una de las características de la litiasis renal es la alta recurrencia y muchas veces la solución de los cólicos requiere de intervenciones endoscópicas u otro tratamiento urológico y esto hace a la morbilidad de la enfermedad. El promedio de diferentes trabajos que estudiaron la evolución natural de la enfermedad muestra que la posibilidad de recurrencia al año del primer episodio es del 15%, a los 5 años 40% y a los 10 años del 60%. Tanto los factores genéticos como los medioambientales contribuyen a la formación de cálculos. Los factores genéticos explican la tendencia a la agregación familiar de la enfermedad. El rol de la herencia es claro en algunas enfermedades como cistinuria o hiperoxalurias primarias, pero la litiasis idiopática también tiene una tendencia familiar, si bien los genes involucrados aún no se conocen. Dentro de los factores medioambientales se destaca la dieta, o sea determinados hábitos de ingesta que expresan la propensión a la litogénesis que tienen algunos sujetos. En aproximadamente 90% de los afectados es posible identificar alteraciones metabólicas que ayudan no sólo al diagnóstico etiológico sino que permiten también un manejo adecuado, con modificaciones dietéticas e intervenciones farmacológicas específicas. El tratamiento es eficaz en disminuir significativamente la tasa de recurrencias. En esta revisión analizamos la fisiopatología de la hipercalciuria, la hiperoxaluria, la hipocitraturia, y las litiasis úrica y cistínica. Se detallan el manejo del cólico renal y el tratamiento dietético y farmacológico apropiado para cada tipo de litiasis.