Abstract:
Background: Urolithiasis is a prevalent condition affecting humans worldwide. The formation of
calcium oxalate stones is the most common type, constituting about 80% of cases. Since currently
available synthetic medications are associated with various side effects, there is a growing interest
in complementary and/or alternative medicines due to their perceived safety, effectiveness, and
lower cost.
Objective: To evaluate the in vitro anti-urolithiatic activity of Hemidesmus indicus (Iramusu) in
inhibiting the formation and growth of urinary stones
Methods: Aqueous and hydro-alcoholic extracts of H. indicus was prepared by washing, drying,
grinding, and using a Soxhlet apparatus. The aqueous extract used 15 g of plant material with 250
mL distilled water for 72 hours, while the hydro-alcoholic extract used 175 mL ethanol and 75 mL
distilled water for 48 hours. Extracts were filtered, concentrated, freeze-dried, and stored at 4°C.
Anti-urolithiatic activity was evaluated using nucleation and growth assays by preparing 1000
ppm to 62.5 ppm concentration series of stem, root, and leaf extracts to check the inhibition of
calcium oxalate crystallization, by using cystone as positive control. Lethality of various extract
concentrations was assessed by using in vitro brine shrimp assay.
Results: When considering both nucleation and growth assays, growth assay showed the highest
inhibition values. The resulting growth inhibition values of aqueous root extract were 44-65% and
the 70% hydro-alcoholic extract exhibited 47-75%. For the aqueous stem extract, the inhibition
values were from 19-25% and for the 70% hydro-alcoholic extract, it was 51-70%. For the
aqueous leaf extract, the inhibition values were 26-59% and for the 70% hydro-alcoholic extract it
was 14-36%. Out of the inhibition percentages, the aqueous extract of the root and 70% hydro
alcoholic extract of the stem showed significant anti-urolithiatic activity (p<0.05). However, only
the aqueous root and leaf extracts showed least toxic nature at the concentrations that showed the
anti-urolithiatic activity.
Conclusions: Comparative analysis indicates that aqueous extracts of root and 70% hydro-alcohol
extract of stem exhibit significant anti-urolithiatic activity. Studies are recommended to formulate
a solid dosage form by incorporating the aqueous root extract for the treatment of urolithiasis due
to the least toxicity to overcome the limitations and adverse effects.
