A Combination of Phyllanthus niruri, Chrysanthellum Americanum, Potassium and Magnesium Citrate Reduces the Risk of Recurrent Urinary Stones

by | Nov 8, 2022 | 2021, Bladder Health, Botanicals

Written by Taylor Woosley, Staff Writer. 6-month treatment of a food supplement containing Phyllanthus niruri, Chrysanthellum Americanum, potassium citrate and magnesium citrate significantly improved QoL scores (p < 0.001) and reduced average stone size in comparison with the baseline (p<0.001). 

kidney and bladder healthUrolithiasis is a growing public health problem worldwide, with an estimated lifetime risk of around 10% of the population in some countries1. Kidney stones are one of the oldest known and widespread diseases in the urinary tract system with a relapse rate of 50% in 5-10 years2. The most common stone components are calcium-based, representing up to 75% of all stone phenotypes, followed by magnesium ammonium phosphate, uric acid, and cystine3. Low urine volume, high urinary excretion of calcium, oxalate, and urate are considered as promotors of stone formation4.

Citrate supplementation, such as magnesium and potassium citrate, has been shown to significantly increase urinary citrate excretion and decrease stone recurrence and formation5. Potassium can moderate the concentration of sodium in urine and promote the elevation of citrate, which acts to correct urinary pH and acidity, thus contributing to an increase in calcium solubility6. Furthermore, medicinal plants such as Chrysanthellum Americanum can be effective in decreasing stone formation due to one of its naturally occurring compounds chrysantellin7. Phyllanthus niruri, also known as “stone breaker”, has beneficial effects on kidney health and may inhibit the formation of kidney stones due to its anti-inflammatory and anti-hyperuricemic properties8.

Cai et al. conducted a prospective study to evaluate the efficacy of a food supplementation containing Phyllanthus niruri and Chrysanthellum Americanum in association with potassium and magnesium citrates in the treatment and prevention of symptomatic episodes in patients with recurrent urinary stones. Subjects (n=82) underwent a urological visit and non-contrast-enhanced CT scan, completed quality of life (QoL) questionnaires, and experienced an anthropometric evaluation and serum chemistry and blood analysis. Inclusion criteria included CT demonstration of one or multiple renal stones up to 15 mm. Outcome measures were the reduction of symptomatic episodes and improvement in questionnaire results. Secondary outcome measures were the reduction of stone dimension and stone-free status at 6 months follow-up CT scan.

Participants were given a food supplement containing 244 mg Potassium citrate, 735 mg Magnesium citrate, Phyllanthus herb d.e. 15% mg Tannins 220 mg, Chrysanthellum plant d.e. ¼ 55 mg once a day for 6 months. After 3 months, subjects were contacted via a phone call to check the adherence to the treatment. After 6 months, participants underwent a second urologic visit, urinalysis and CT scan and completed QoL questionnaires. T-test was used to compare average performance between the beginning of the study and after enrollment. Significant findings of the 6-month trial are as follows:

  • Twenty-seven patients out of 82 had no evidence of stone at the non-contrast-enhanced CT scanner (32.9%) at the end of the follow-up evaluation, reporting stone expulsion, while 50 patients showed lower stones dimension (60.9%).
  • The average stone sizes at the end of the follow-up was 0.9 mm (±1 mm), with a significant reduction in comparison with the baseline (-6.7 mm ± 3 mm) (p<0.001).
  • Forty-nine patients had an improvement in QoL (+0.4 ±1) (p<0.001) in comparison to the baseline.

Findings of the prospective study demonstrate that a food supplement containing Phyllanthus niruri, Chrysanthellum americanum, potassium citrate and magnesium citrate improves QoL in subjects with recurrent urinary stones. Furthermore, after 6 months, the rate of stone expulsion and average stone size was greatly improved. Future research should explore the effects of this food supplementation on a larger subject group to continue to better understand the benefits of Phyllanthus niruri, Chrysanthellum americanum, potassium citrate and magnesium citrate on stone reduction and symptom improvement.

Source: Cai, Tommaso, Daniele Tiscione, Marco Puglisi, Gianni Malossini, Lorenzo Ruggera, Paolo Verze, Davide Arcaniolo, and Alessandro Palmieri. “Phyllanthus niruri and Chrysanthellum americanum in association with potassium and magnesium citrates are able to prevent symptomatic episode in patients affected by recurrent urinary stones: A prospective study.” Archivio Italiano di Urologia e Andrologia 93, no. 2 (2021): 184-188.

Click here to read the full text study.

Posted November 8, 2022.

Taylor Woosley studied biology at Purdue University before becoming a 2016 graduate of Columbia College Chicago with a major in Writing. She currently resides in Glen Ellyn, IL.

References:

  1. Letavernier E, Daudon M. Vitamin D, Hypercalciuria and Kidney Stones. Nutrients. Mar 17 2018;10(3)doi:10.3390/nu10030366
  2. Nirumand MC, Hajialyani M, Rahimi R, et al. Dietary Plants for the Prevention and Management of Kidney Stones: Preclinical and Clinical Evidence and Molecular Mechanisms. Int J Mol Sci. Mar 7 2018;19(3)doi:10.3390/ijms19030765
  3. Bargagli M, Ferraro PM, Vittori M, Lombardi G, Gambaro G, Somani B. Calcium and Vitamin D Supplementation and Their Association with Kidney Stone Disease: A Narrative Review. Nutrients. Dec 4 2021;13(12)doi:10.3390/nu13124363
  4. Ferraro PM, Bargagli M, Trinchieri A, Gambaro G. Risk of Kidney Stones: Influence of Dietary Factors, Dietary Patterns, and Vegetarian-Vegan Diets. Nutrients. Mar 15 2020;12(3)doi:10.3390/nu12030779
  5. Wiegand A, Fischer G, Seeger H, et al. Impact of potassium citrate on urinary risk profile, glucose and lipid metabolism of kidney stone formers in Switzerland. Clin Kidney J. Dec 2020;13(6):1037-1048. doi:10.1093/ckj/sfz098
  6. Pucci ND, Marchini GS, Mazzucchi E, et al. Effect of phyllanthus niruri on metabolic parameters of patients with kidney stone: a perspective for disease prevention. Int Braz J Urol. Jul-Aug 2018;44(4):758-764. doi:10.1590/s1677-5538.Ibju.2017.0521
  7. Cai T, Tiscione D, Puglisi M, et al. Phyllanthus niruri and Chrysanthellum americanum in association with potassium and magnesium citrates are able to prevent symptomatic episode in patients affected by recurrent urinary stones: A prospective study. Arch Ital Urol Androl. Jun 28 2021;93(2):184-188. doi:10.4081/aiua.2021.2.184
  8. Li MT, Liu LL, Zhou Q, et al. Phyllanthus Niruri L. Exerts Protective Effects Against the Calcium Oxalate-Induced Renal Injury via Ellgic Acid. Front Pharmacol. 2022;13:891788. doi:10.3389/fphar.2022.891788