Identification of medicinal plants for the treatment of kidney and urinary stones

Abstract

Introduction: Kidney stones are the third most common urinary tract problems after urinary tract infections and prostate pathology. Kidney stones may cause extreme pain and blockage of urine flow. They are usually treated with medications that may cause a number of side-effects. Medicinal herbs are used in different cultures as a reliable source of natural remedies.
Objectives: This study aimed to determine native medicinal plants used by traditional healers of Shiraz for the treatment of kidney stones.
Materials and Methods: The ethno-medicinal data were collected between July and September 2012 through face-to-face interview with local herbalist.
Results: A total of 18 species belonging to 19 botanical families were recorded in study area. Species with the highest frequency of mentions were Alhagi maurorum (51.58%), Tribulus terrestris (51.58%), and Nigella sativa (48.14). The most frequently used plant parts were aerial parts (38%), leaf (33%) and fruits (17%). Decoction (68%) was the most frequently prescribed method of preparation. Most of the medicinal plants recommended by Shirazian herbalists have not been investigated in animal and humane models of renal stone which provides a new area of research.
Conclusion: In the case of safety and effectiveness, they can be refined and processed to produce natural drugs.

Full text

Journal of Renal Injury Prevention
J Renal Inj Prev. 2016; 5(3): 129-133.
Identification of medicinal plants for the treatment of
kidney and urinary stones
*Corresponding author: Nasrollah Naghdi; Email; dr.naghdi93@gmail.com
http://journalrip.com DOI: 10.15171/jrip.2016.27
Mahmoud Bahmani1, Babak Baharvand-Ahmadi2, Pegah Tajeddini3, Mahmoud Rafieian-Kopaei3, Nasrollah
Naghdi4*
1Razi Herbal Medicines Research Center, Lorestan University of Medical Sciences, Khorramabad, Iran
2Madani Heart Hospital, Department of Cardiovascular, Faculty of Medicine, Lorestan University of Medical Sciences, Khorramabad, Iran
3Medical Plants Research Center, Shahrekord University of Medical sciences, Shahrekord, Iran
4Clinical Microbiology Research Center, Ilam University of Medical Sciences, Ilam, Iran
Implication for health policy/practice/research/medical education:
Kidney stones known as a renal calculus which it is a solid piece of material which is formed in the kidneys from minerals in
urine. Kidney stones typically leave the body in the urine stream, and a sma ll stone may pass without causing symptoms. The use
of herbs in the prevention and treatment of kidney stones is a useful strategy. In this study, we have reported 18 species in Shiraz
which were used for the treatment of renal calculus which could have the potential to produce natural remedies for removed
kidney stone.
Please cite this paper as: Bahmani M, Baharvand-Ahmadi B, Tajeddini P, Rafieian-Kopaei M, Naghdi N. Identification of
medicinal plants for the treatment of kidney and urinary stones. J Renal Inj Prev. 2016 ;5(3):129-133. DOI: 10.15171/jrip.2016.27
Introduction: Kidney stones are t he third most common urinar y tract problems after urina ry
tract infections and prostate pathology. Kidney stones may cause extreme pain and blockage
of urine f low. They are usually treated with medications that may cause a number of side-
effects. Medicinal herbs are used in different cultures as a reliable source of natural remedies.
Objectives: This study aimed to determine native medicinal plants used by traditional healers
of Shiraz for the treatment of kidney stones.
Materials and Methods: The ethno-medicinal data were collected between July and
September 2012 through face-to-face interview with local herbalist.
Results: A total of 18 species belonging to 19 botanical families were recorded in study area.
Species with the highest frequency of mentions were Alhagi maurorum (51.58%), Tribulus
terrestris (51.58%), and Nigella sativa (48.14). The most frequently used plant parts were aerial
parts (38%), leaf (33%) and fruits (17%). Decoction (68%) was the most frequently prescribed
method of preparation. Most of the medicinal plants recommended by Shirazian herbalists
have not been investigated in animal and humane models of renal stone which provides a new
area of research.
Conclusion: In the case of safety and effectiveness, they can be refined and processed to
produce natural drugs.
A R T I C L E I N F O
Keywords:
Kidney stones
Medicinal plants
Iran
Article History:
Received: 29 May 2016
Accepted: 13 July 2016
Published online: 27 July 2 016
Article Type:
Original
A B S T R A C T
Introduction
Kidney stones are the third most common urinary tract
problems, after urinary tract infections and prostate dis-
eases. Most people with kidney stones suffer from severe
colic pains that are not relieved by conventional pain kill-
ers and may require narcotic analgesics. In addition to
pain, urinary tract obstruction, urinary tract infection,
hydronephrosis and severe bleeding may occur and in
some cases, surgery is required to remove or break stones
(1). The introduction of ESWL in the 1980s revolutionized
the treatment of urinary stones. Today, more than 90% of
patients with upper urinary tract stones are treated based
on the size, type and location of the stone, with a treat-
ment success rate of 68%-86% (2). It is has been reported
that increased dietary protein intake may elevate the rates
of developing kidney stones. Kidney stones are common
clinical disorders and have both high incidence and high
prevalence in the world. The prevalence of kidney stones is
influenced by geographic location, lifestyle, race/ethnicity
and other factors. In different studies, its world prevalence
Original

Journal of Renal Injury Prevention, Volume 5, Issue 3, September 2016 http://journalrip.com
130
Bahmani M et al
has been reported to be about 1%-15%. Iran has a high in-
cidence of kidney stones prevalence. Approximately 75%
of all kidney stones are calcium stone which composed of
calcium oxalate and/or calcium phosphate (3).
It has been estimated that 80% of the world’s population
relies on traditional medicine to treat their diseases (4).
Medicinal plants have a long history of use and are global-
ly safer than synthetic drugs (5). They are a reliable source
for drug discovery (6). Today, researchers have focused on
the drug discovery from medicinal plants (7). It has been
estimated that at least one third of all medicinal product
have plant origin (8). Medicinal plants are regarded as an
acceptable, cheap, easily available and safe source of ac-
tive compounds for pharmaceutical (9). The therapeutic
effects of medicinal plants on kidney and urinary tract
disorders have been variously studied and their efficacy
has been demonstrated (10).
Objectives
A wide variety of medicinal plants are used in Iranian
traditional medicine to treat kidney disorders (11). This
study aimed to determine the native medicinal plants used
by traditional healers of Shiraz for the treatment of kidney
stone.
Materials and Methods
The study area
This study was conducted in Shiraz which is located in the
southwest of Iran. Shiraz is one of the largest cities in Iran
and is the capital of Fars province. The city has a length
of 40 km, a width of 15-30 km and a total area of 1268
km2. The population of this city was 1 460 665 in 2009. It
has a moderate climate and lies in the Zagros mountain
range at an altitude of 1468 m. It is surrounded by Kuh-e
Sabz Pushan, Kuh-e Bamu, Kuh-e Chel Magham in the
north and Kuh-e Drak in the west. The coldest month of
the year is January, with an average temperature of 5℃ and
the warmest month is July with an average temperature of
30℃. The average annual temperature is about 18℃ and
the average annual rainfall is 3378 mm (12).
The methodology of ethno-medicinal data collection
The ethno-medicinal data were collected between July
and September 2012 through face-to-face interview with
local herbalist and herbal healers. Herbalists were inter-
viewed in their herbal stores with the aid of semi-struc-
tured questionnaires. Questionnaires were included herb-
alist personal information, plant local name, plant growth
season, plant parts used, preparation methods, and tradi-
tional therapies. Questionnaires data were transferred to
Microsoft Excel.
Ethical issues
The research followed the tenets of the Declaration of Hel-
sinki. The research was approved by the ethical committee
of Shahrekord University of Medical Sciences.
Statistical analysis
Data collected from local herbalist was analyzed using Mi-
crosoft Excel 2007.
Results
Ethno-medicinal information of plants used in the man-
agement of kidney stone in Shiraz are shown in Tab l e 1.
A total of 18 species belonging to 19 botanical families
are used to treat kidney stone in Shiraz. The number of
mentions of each plant spices for the treatment of kidney
stone is shown in Tabl e 2. Species with the highest fre-
quency of mentions in the interview were Alhagi mau-
rorum (51.58%), Tribulus terrestris (51.58%), Nigella Sa-
tiva (48.14%), Mangifera indica (44.44%), Prunus cerasus
(37.03%), Prangos acaulis (DC.) Bornm (33.33%). Botani-
Table 1. Medicinal plant recommended for the treatment of kidney stone; scientic name, common name, family name, plant parts used and
preparation methods
Scienc name Family Persian names Usable part of plant How to use Tradional therapeuc
eect in Shiraz
Alhagi maurorum Fabaceae Kharshotor Aerial parts Decocon Kidney stone
Tribulus terrestris Zygophyllaceae Kharkhasak Aerial parts Decocon Kidney stone
Nigella Sava Caryophyllaceae Siahdaneh Seed Decocon Kidney stone
Althea aucheri Boiss. Malvaceae Khatmi-armanestani Aerial parts Decocon Kidney stone
Lactuca sava L Compositae Kahoo Leave Fresh Kidney stone
Prunus cerasus Rosaceae Albaloo Fruit Fresh Kidney stone
Alhagi camelorum Papilionaceae Taranjebin Aerial parts Decocon Kidney stone
Mangifera indica Anacardiaceae Anbeh Fruit Fresh Kidney stone
Prangos acaulis (DC.) Bornm Apiaceae Jashi-kotoleh Aerial parts Decocon Kidney stone
Urca dioica L Urcaceae Gazaneh Aerial parts Decocon Kidney stone
Fumaria ocinalis Fumariaceae Shah-tareh Leave Decocon and fresh Kidney stone
Plantago psyllium Plantaginaceae Esfarzeh Leave Decocon Kidney stone
Medicago sava Leguminosae Yonjeh Decocon Decocon Kidney stone
Apium graveolens Umbelliferae Karafs Decocon Decocon Kidney stone
Rheum ribes Polygonaceae Rivas Fruit Fresh Kidney stone
Arcum lappa Compositae Baba-adam Aerial parts Decocon Kidney stone
Pimpinella anisum Apiaceae Anison Aerial parts Decocon Kidney stone
Gundelia tournefori Asteraceae Kangar Leave Fresh Kidney stone

Journal of Renal Injury Prevention, Volume 5, Issue 3, September 2016
http://journalrip.com 131
Medicinal plants for urinary stones
cal families recommended by Shirazian herbalist for the
treatment of kidney stone are shown in Figure 1. Apia-
ceae was the most commonly recommended family. As
shown in Figure 2 the most frequently used plant parts
were aerial parts (38%), leaf (33%) and fruits (17%). De-
coction (68%) was the most frequently prescribed method
of preparation (Figure 3).
Discussion
We collected local knowledge of Shirazian herbal healers
on medicinal plants used in the treatment of kidney stone.
A total of 18 species belonging to 19 botanical families are
used to treat kidney stone in Shiraz. The most frequen-
cy used plant Species were Alhagi maurorum (51.58%),
Tribulus terrestris (51.58%), Nigella sativa (48.14%), Man-
gifera indica (44.44%), Prunus cerasus (37.03%) and Pran-
gos acaulis (DC.).
A wide variety of medicinal plants are used to treat renal
stones in different parts of Iran. In ethno-botany of Kaze-
roon Nasturtium officinale (L.) R. Br., Alhaji camelorum,
and Tribulus terrestris L. are used to treat kidney stone
(13). Alhagi persarum Boiss & Buhse and Rubia tinctorum
Table 2. The number of mentions of each plant spices for the treatment of kidney stone
Scienc name The number of herbalists
menoned the plant
The total number of
herbalists
Frequency of citaon (FC)
percentage (%)
Alhagi maurorum 14 27 51.58
Tribulus terrestris 14 27 51.58
Nigella Sava 13 27 48.14
Althea aucheri Boiss. 7 27 25.92
Lactuca sava L 5 27 18.51
Prunus cerasus 10 27 37.03
Alhagi camelorum 12 27 44.44
Mangifera indica 9 27 33.33
Prangos acaulis (DC.) Bornm 2 27 7.40
Urca dioica L 3 27 11.11
Fumaria ocinalis 5 27 18.51
Plantago psyllium 4 27 14.81
Medicago sava 5 27 18.51
Apium graveolens 4 27 14.81
Rheum ribes 2 27 7.40
Arcum lappa 4 27 14.81
Pimpinella anisum 2 27 7.40
Gundelia tournefori 5 27 18.51
Figure 1. Botanical family recommended by Shirazian herbalist
for the treatment of kidney stone.
Figure 2. The percentage of different plant parts used to cure
kidney stone in Shiraz
Figure 3. The percentage of different preparation methods of
medicinal plant for the treatment of kidney stone in Shiraz.
33%
6%
44%
17%
Leaf
Seed
Areal parts
Fruit
32%
68%
Fresh edible
Decoction
are used in Sistan and Baluchestan Province (southeastern
Iran), to treat kidney stone (14). In Kashan ethnobotany,
Cousinia alexeenkoana Bornm is used for this purpose
(15). Kerman people believed that Petroselinum hortense
can break up kidney stones (16). Achillea santolina, Mat-
ricaria recutita L., Cuminum cyminum L., Nigella sativa
L., Raphanus sativus L, Zea mays L., Plantago psyllium L.,

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132
Bahmani M et al
Linum usitatissimum L., Tribulus terrestris L., Prunus cera-
sus L and Foeniculum vulgare Mill are used by Kurd tribe
in Dehloran and Abdanan district, Ilam province for the
treatment of kidney stones (17). Adiantum capillus-vener-
is, Alhagi persarum Boiss, Allium akaka Gmelin, Cerasus
mahaleb (L.) Miller, Gundelia tournefortii L., and Noaea
mucronata (Forssk.) are traditionally used in Ilam Prov-
ince as a means of breaking up kidney stones (18). Celery
is widely used to treat kidney stone (19). Its essential oil
contains chrysoeriol 7-O-diglucoside, Luteolin, 7-O-apio-
sylglucoside and Luteolin7-O (20).
A comparison of medicinal plants used in different parts
of Iran shows that Nigella sativa, Prunus cerasus, Tribu-
lus terrestris, and Alhagi camelorum are commonly used
in different parts and cities for the treatment of kidney
stones. The efficacy of some of these plants in treating kid-
ney stone and other kidney diseases has been investigated
in different studies (21,22). The effects of Nigella sativa L
extract on ethylene glycol-induced kidney calculi in rats
was investigated. Ethanolic extract of Nigella sativa sig-
nificantly reduced the number of calcium oxalate deposits
in rat kidney (23). In the study conducted by Shafaeifar et
al, the effect of hydrophilic extract of Alhagi maurorum
was investigated on ethylene glycol-induced renal stone
formation in rats. Their results showed that the hydro-
philic extract of Alhagi maurorum can reduce urinary
oxalate concentration and urinary calcium oxalate stones
formation (24). The effect of Tribulus terrestris extract on
calcium oxalate crystallization in NRK 52E renal epithelial
cells was investigated in the Aggarwal et al study. Tribulu s
terrestris extract significantly inhibited nucleation and the
growth of the CaOx crystals (25).
Most of the medicinal plants recommended by Shirazian
herbalist have not been investigated in animal and hu-
mane models of renal stone which provides a new area of
research. In the case of safety and effectiveness, they can
be refined and processed to produce natural drugs.
Conclusion
In the case of safety and effectiveness, they can be refined
and processed to produce natural drugs.
Limitations of the study
This study limited to a Shiraz city. The same study in vari-
ous parts of Iran suggests.
Acknowledgments
The authors accomplish this research by the support of
Shahrekord University of Medical Sciences, Shahrekord,
Iran (Grant# 1842/5).
Authors’ contribution
All the authors wrote the first draft of the manuscript
equally. MRK revised and edited the last version.
Conflicts of interest
The author(s) declared no potential conflicts of interest
with respect to the research, authorship, and/or publica-
tion of this article.
Ethical considerations
Ethical issues (including plagiarism, data fabrication,
double publication) have been completely observed by
authors.
Funding/Support
The author(s) disclosed receipt of the following financial
support for the research, authorship, and/or publication
of this article: This article was prepared by support of
Research Deputy of Shahrekord University of Medical
Sciences.
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