June 21, 2021

Pathophysiology of kidney, gallbladder and urinary stones treatment with herbal and allopathic medicine: A review

1Department of Pharmacognosy, Institute of Pharmacy, Bundelkhand University, Jhansi (U.P.), India

2Department of Pharmaceutical Sciences, Faculty of Health Sciences, Sam Higginbottom Institute of Agriculture, Technology and Sciences-Deemed University, Allahabad (U.P.), India

3Society of Pharmaceutical Sciences and Research, Haryana (H.R.),India

Reviewed by : Shruti Rawal University of Otago, Dunedin, New Zealand., E-mail: moc.liamg@5841iturhs


Medicinal plants have been known for millennia and are highly esteemed all over the world as a rich source of therapeutic agents for the prevention of various ailments. Today large number of population suffers from kidney stone, gall stone and urinary calculi. Stone disease has gained increasing significance due to changes in living conditions i.e. industrialization and malnutrition. Changes in prevalence and incidence, the occurrence of stone types and stone location, and the manner of stone removal are explained. Medicinal plants are used from centuries due to its safety, efficacy, cultural acceptability and lesser side effects as compared to synthetic drugs. The present article deals with measures to be adopted for the potential of medicinal plants in stone dissolving activity. The problem of urinary stones or calculi is a very ancient one and many remedies have been employed during the ages these stones are found in all parts of the urinary tract, the kidney, the ureters and the urinary bladder and may vary considerably in size. In the present article, an attempt has been made to emphasis on herbal option for urinary stone.

1. Introduction

Nature bestowed our country with an enormous wealth of medicinal plants. Plants have been used as traditional healthcare system from the centuries. The WHO has listed 20 000 medicinal plants globally in which contribution of India is 15–20%[1]. The WHO reported that 80% of global countries depend on the medicinal plants[2]. A large body of evidence has collected to show potential of medicinal plants used in various traditional systems. In the last few years more than 13 000 plants have been studied for the various diseases and ailments all over the world[3]. Kidney stones are also major disorders prevailing all over the world. About 75% of kidney stones are composed of calcium oxalate crystals[4].

Gall stone mainly affects people in global countries. More than half a million people are affected annually in United States and more than 50 000 people in Canada. Canada endures surgical treatment to remove their gall bladder because of gall stone. About 80 % of all the gall stones has evidence for no symptoms and may continue for years[5]. Also, the over use of synthetic drugs, which results in higher incidence of adverse drug reactions, has motivated humans to return to nature for safe remedies. The origins, according to many, can be sourced to the World Health Organization’s Canberre conference in 1976, which promoted the concept of ‘Traditional’ medicines for the developing countries[6].

The problem of urinary stones or calculi is a very ancient one and many remedies have been employed during the ages these stones are found in all parts of the urinary tract, the kidney, the ureters and the urinary bladder and may vary considerably in size, Linacre, who had founded the college of physicians, died of urinary stone in 1518 in London, a condition he could diagnose but could not be true.

2. Pathophysiology

2.1. Kidney stone

Kidney stone are called as renal calculi. They are crystal aggregations formed in the kidneys. Kidney stones normally leave the body by the route of urine stream, and many stones are produced and conceded without causing symptoms. If stones grow to plenty size before passage, on the order of at least 2–3 millimeters, they can cause barrier of the ureter[8]. The whole summary kidney stone path physiology is given in Figure 1 and Table 1.

2.3. Lithiasis

A kidney stone is a hard mass developed from crystals that separate from the urine within the urinary tract. Normally, urine contains chemicals that prevent or inhibit the crystals from urinary tract. These crystals remain tiny enough; they will travel through the urinary tract and pass out of the body in the urine without being noticed. A less common type of stone is caused by infection in the urinary tract. This stone is called struvite or infection stone. Another type of stone, uric acid stones, are a bit less common, and cystine stones rare[8]. Kidney stones are composed of inorganic and organic crystals amalgamated with proteins. Crystallisation and subsequent lithogenesis can happen with many solutes in the urine. Calcareous stones are still by far the most common nephroliths, 17 % accounting for more than 80% of stones[21].

2.4. Gall bladder stone

Gallstones are collections of cholesterol, bile pigment, which can form in the gallbladder or surrounded by the bile ducts of the liver. In the United States, the most universal category of gallstones is made of cholesterol. Cholesterol stones are mainly causes due to difference in the production of cholesterol or the secretion of bile. Pigmented stones are mainly composed of bilirubin, which is an element formed due to the normal breakdown of red blood cells. Bilirubin gallstones are more common in Asia and Africa but they are seen in diseases that break red blood cells such a sickle cell anemia[22]. The whole summary gallbladder stone path physiology is given in Figure 2 and Table 2.

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