Background:
Nephrolithiasis is a prevalent urological condition with high recurrence rates, largely driven by metabolic abnormalities such as hypercalciuria, hyperoxaluria, hyperuricosuria, and hypocitraturia. Phyllanthus niruri (commonly known as Chanca Piedra) has been traditionally used for the management of urinary stones, yet clinical evidence supporting its metabolic effects has remained limited.
Objective:
To evaluate the effects of Phyllanthus niruri on urinary metabolic parameters and stone-related outcomes in patients with urolithiasis, with a focus on mechanisms influencing crystal formation and elimination.
Methods:
Clinical evidence from prospective, controlled, and observational studies assessing P. niruri administration in stone-forming patients was reviewed. Key endpoints included changes in 24-hour urinary biochemical parameters, stone burden assessed by ultrasonography, and safety outcomes.
Results:
Across multiple studies, P. niruri intake was found to be safe and well tolerated, with no clinically significant adverse effects on serum biochemical parameters. Subgroup analyses demonstrated a significant reduction in urinary calcium among hypercalciuric patients, along with decreases in urinary oxalate and uric acid in individuals with hyperoxaluria and hyperuricosuria. Increases in urinary magnesium and potassium-known inhibitors of calcium oxalate crystallization-were also observed. Imaging findings revealed a reduction in stone number and size in a proportion of patients, suggesting facilitation of stone fragmentation and elimination.
Conclusion:
Phyllanthus niruri favourably modulates key urinary metabolic risk factors associated with nephrolithiasis and may contribute to stone prevention and clearance, particularly in patients with defined metabolic abnormalities. These findings support its role as a safe adjunctive therapy in the metabolic management of kidney stone disease, warranting further large-scale, long-term clinical trials.
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