Background
Urolithiasis is a common condition with high recurrence rates and significant healthcare burden. Despite advances in surgical and pharmacological management, effective chemolytic options remain limited, particularly for calcium-based stones. This has led to increasing patient interest in alternative therapies such as Phyllanthus niruri, a widely used herbal remedy with purported anti-urolithic effects but limited high-quality clinical evidence.
Objective
To evaluate the clinical efficacy of Phyllanthus niruri in reducing kidney stone burden (size and number) through systematic review and meta-analysis, and to assess public interest in the therapy using Google Trends data.
Method
A systematic literature search was conducted across PubMed, Google Scholar, Cochrane Library, and SCOPUS databases following PRISMA guidelines. Controlled human studies evaluating the effect of P. niruri on stone size and number were included. Data were pooled using a fixed-effects model, reporting standardized mean difference (SMD) with 95% confidence intervals. Additionally, Google Trends analysis was performed to compare relative search volume (RSV) of P. niruri with conventional surgical interventions (ESWL, URS, PCNL, URSL) in the United States from 2014–2018.
Result
Two clinical studies met inclusion criteria, comprising 89 patients treated with P. niruri and 92 controls. Meta-analysis demonstrated a statistically significant reduction in mean stone size (SMD −0.39 cm; 95% CI: −0.68 to −0.09; p=0.01) and stone number (SMD −0.38; 95% CI: −0.68 to −0.09; p=0.01). However, heterogeneity between studies was moderate to high. Google Trends analysis revealed increasing public interest in P. niruri, with search volumes surpassing those for some conventional surgical modalities in recent years.
Conclusion
Phyllanthus niruri demonstrates modest but statistically significant efficacy in reducing kidney stone burden, though evidence remains limited by small sample sizes and study heterogeneity. The growing public interest underscores the need for larger, well-designed clinical trials to validate its therapeutic role and inform integration into evidence-based urological practice.
