An overview of multi-ingredient kidney stone dissolving formulations from Traditional Persian Pharmacy

Document Type : Review Article

Authors

1 Medicinal Plants Processing Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

2 Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

3 Department of Clinical Pharmacy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

4 Department of Persian Medicine, Shiraz University of Medical Sciences, Shiraz, Iran

5 Department of Pharmacognosy, School of Pharmacy, Shiraz University of Medical Sciences, Shiraz, Iran

6 Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

Abstract

Kidney stone, as a third important urinary tract disease, is a common disease affecting 10-15% of the world population. Effective medical treatment for the disease is not yet well established. On the other hand, there is an increasing global demand to manage and control various diseases with natural medicine and medicaments originating from Complementary and Alternative Medicine (CAM). Traditional Persian medicine (TPM), as one of the most popular schools in CAM, suggests numerous clinical interventions for kidney stones. This review provides various related compound formulations for kidney/bladder stones from the standpoints of Persian scholars. These remedies have been cited in a series of traditional pharmaceutical manuscripts of Persian medicine, namely Qarābādin or prescription. More than fifty multi-ingredient formulations for kidney/bladder stones have been found by reviewing five main Persian pharmacopeias. Various dosage forms have been reported for the management of kidney/bladder stones, such as Majoon (confection), Sharāb (syrup), Jawārish (semisolid confection), Qors (Tablet), and Safoof (oral powder). Considering the positive pharmacological or biological activities of the constituents of filtered formulations, many of those can be re-formulated and either experimentally or clinically evaluated to be introduced as new natural remedies in this field.

Keywords


1.    Du H, Lei Y, Gao AN, Sun XM, Song R, Yu XD, et al. Traditional Chinese medicine combined with conventional therapy for female kidney stone: A protocol for systematic review. Medicine (Baltimore). 2020 Mar;99(13):e19611. doi: 10.1097/MD.0000000000019611. PMID: 32221084; PMCID: PMC7220068.
2.    Kamboj P, Aggarwal M, Puri S, Singla SK. Effect of aqueous extract of Tribulus terrestris on oxalate-induced oxidative stress in rats. Indian J Nephrol. 2011 Jul;21(3):154-9. doi: 10.4103/0971-4065.83727. PMID: 21886973; PMCID: PMC3161431.
3.    Merchant ML, Cummins TD, Wilkey DW, Salyer SA, Powell DW, Klein JB, et al. Proteomic analysis of renal calculi indicates an important role for inflammatory processes in calcium stone formation. Am J Physiol Renal Physiol. 2008 Oct;295(4):F1254-8. doi: 10.1152/ajprenal.00134.2008. Epub 2008 Aug 13. PMID: 18701630; PMCID: PMC2576136.
4.    Lieske JC, Peña de la Vega LS, Slezak JM, Bergstralh EJ, Leibson CL, Ho KL, et al. Renal stone epidemiology in Rochester, Minnesota: an update. Kidney Int. 2006 Feb;69(4):760-4. doi: 10.1038/sj.ki.5000150. PMID: 16518332.
5.    Hughes P; Caring for Australians with Renal Impairment (CARI). The CARI guidelines. Kidney stones epidemiology. Nephrology (Carlton). 2007 Feb;12 Suppl 1:S26-30. doi: 10.1111/j.1440-1797.2006.00724.x. PMID: 17316273.
6.    Sas DJ. An update on the changing epidemiology and metabolic risk factors in pediatric kidney stone disease. Clin J Am Soc Nephrol. 2011 Aug;6(8):2062-8. doi: 10.2215/CJN.11191210. Epub 2011 Jul 7. PMID: 21737846.
7.    Pearle MS, Goldfarb DS, Assimos DG, Curhan G, Denu-Ciocca CJ, Matlaga BR, Monga M, Penniston KL, Preminger GM, Turk TM, White JR; American Urological Assocation. Medical management of kidney stones: AUA guideline. J Urol. 2014 Aug;192(2):316-24. doi: 10.1016/j.juro.2014.05.006. Epub 2014 May 20. PMID: 24857648.
8.    Coe FL, Parks JH, Asplin JR. The pathogenesis and treatment of kidney stones. N Engl J Med. 1992 Oct 15;327(16):1141-52. doi: 10.1056/NEJM199210153271607. PMID: 1528210.
9.    Pak CY. Pharmacotherapy of kidney stones. Expert Opin Pharmacother. 2008 Jun;9(9):1509-18. doi: 10.1517/14656566.9.9.1509. PMID: 18518781.
10.    Atmani F. Medical management of urolithiasis, what opportunity for phytotherapy? Front Biosci. 2003 May 1;8:s507-14. doi: 10.2741/1081. PMID: 12700097.
11.    Butterweck V, Khan SR. Herbal medicines in the management of urolithiasis: alternative or complementary? Planta Med. 2009 Aug;75(10):1095-103. doi: 10.1055/s-0029-1185719. Epub 2009 May 14. PMID: 19444769; PMCID: PMC5693348.
12.    Coe FL, Evan A, Worcester E. Kidney stone disease. J Clin Invest. 2005 Oct;115(10):2598-608. doi: 10.1172/JCI26662. PMID: 16200192; PMCID: PMC1236703.
13.    Unno R, Kawabata T, Taguchi K, Sugino T, Hamamoto S, Ando R, Okada A, Kohri K, Yoshimori T, Yasui T. Deregulated MTOR (mechanistic target of rapamycin kinase) is responsible for autophagy defects exacerbating kidney stone development. Autophagy. 2020 Apr;16(4):709-723. doi: 10.1080/15548627.2019.1635382. 
14.    Ekor M. The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Front Pharmacol. 2014 Jan 10;4:177. doi: 10.3389/fphar.2013.00177. PMID: 24454289; PMCID: PMC3887317.
15.    Jayanthi M, Dhar M, Jayanthi M. Anti-inflammatory effects of Allium sativum (Garlic) in experimental Rats. Biomedicine. 2011;31(1):84-9.
16.    Mencherini T, Cau A, Bianco G, Della Loggia R, Aquino RP, Autore G. An extract of Apium graveolens var. dulce leaves: structure of the major constituent, apiin, and its anti-inflammatory properties. J Pharm Pharmacol. 2007 Jun;59(6):891-7. doi: 10.1211/jpp.59.6.0016. PMID: 17637182.
17.    Ansari R, Dadbakhsh A, Hasani F, Hosseinzadeh F, Abolhassanzadeh Z, Zarshenas MM. Traditional Aspects of Sciatic Pain Management and Allied Therapies from Persian Medical Reports. Curr Drug Discov Technol. 2021;18(2):194-206. doi: 10.2174/1570163817666200316112120. PMID: 32178615.
18.    Kargarsharifabad F, Tavasoli S, Heydarirad G, Amiri FB, Jalali S, Basiri A, et al. Dietary Recommendations for Urinary Stones, From the Perspective of Persian Medicine and Comparison with Current Management. Ann Romanian Soc Cell Biol. 2021 May 5:2260-7.
19.    Changizi Ashtiyani S, Cyrus A. Rhazes, a genius physician in diagnosis and treatment of kidney calculi in medical history. Iran J Kidney Dis. 2010 Apr;4(2):106-10. PMID: 20404418. 
20.     Avicenna. (1025/1988). Canon of Medicine Vol. 5. Tehran, Iran: Soroosh Press (in Persian).
21.    Baranifard M, Khazaei M, Jamshidi S, Zarshenas M, Zargaran A. A critical comparison between dosage forms in traditional Persian pharmacy and those reported in current pharmaceutical sciences. Res J Pharmacog. 2017;4(3):67-74.
22.     Aghili Shirazi SMH. (1772/1855). Qarabadin-e-Kabir. Tehran, Iran: Ostad Allah Qoli khan Qajar (in Persian).
23.    Heravi MG. (1765). Qarabadin-e-Salehi. Tehran, Iran: Dar-ol-khalafeh (Litograph in Persian).
24.    Arzani A. (1714/1861). Qarabadin-e-Ghaderi. Tehran, Iran: Mohammadi publication (Lithograph in Persian).
25.     Azamkhan MAK. (1853/2004). Qarabadin-e-Azam. Tehran, Iran: Intisharat va Amoozesh Enghelab Islami Press (in Persian).
26.    Faridi P, Seradj H, Mohammadi-Samani S, Vossoughi M, Mohagheghzadeh A, Roozbeh J. Randomized and double-blinded clinical trial of the safety and calcium kidney stone dissolving efficacy of Lapis judaicus. J Ethnopharmacol. 2014 Oct 28;156:82-7. doi: 10.1016/j.jep.2014.08.003. Epub 2014 Sep 1. PMID: 25193008.
27.    Aggarwal A, Tandon S, Singla SK, Tandon C. A novel antilithiatic protein from Tribulus terrestris having cytoprotective potency. Protein Pept Lett. 2012 Aug;19(8):812-9. 
doi: 10.2174/092986612801619552. PMID: 22702898.
28.    Ibrahim FY, El-Khateeb A. Effect of herbal beverages of Foeniculum vulgare and Cymbopogon proximus on inhibition of calcium oxalate renal crystals formation in rats. Ann Agric Sci. 2013;58(2):221-9.
29.    Uzun E, Sariyar G, Adsersen A, Karakoc B, Otük G, Oktayoglu E, Pirildar S. Traditional medicine in Sakarya province (Turkey) and antimicrobial activities of selected species. J Ethnopharmacol. 2004 Dec;95(2-3):287-96. doi: 10.1016/j.jep.2004.07.013. PMID: 15507351.
30.    Pethakar SR, Hurkadale PJ, Hiremath RD. Evaluation of Antiurolithiatic Potentials of Hydro-Alcoholic Extract of Cucumis sativus L. Indian J Pharm Educ Res. 2017;51(4S):607-14.
31.    Al Jawad FH, Al Razzuqi RA, Al Jeboori AA. Apium graveolens accentuates urinary Ca+ 2 excretions in experimental model of nephrocalcinosis. Int J Green Pharm (IJGP). 2011;5(2):100-2.
32.    Ravishankar K, Priya P. In vitro antioxidant activity of ethanolic seed extracts of Macrotyloma uniflorum and Cucumis melo for therapeutic potential. IJRPC. 2012;2(2):442-5.
33.    Ullah N, Khan S, Khan A, Ahmad W, Shah Y, Ahmad L, et al. A prospective pharmacological review of medicinal herbs, Cucumis melo and Berberis vulgaris, commonly used in the treatment of renal diseases in Pakistan. Acta Pol Pharm. 2015 Jul-Aug;72(4):651-4. PMID: 26647620.
34.    Shehzad A, Saleem U, Shah MA, Vargas-de la Cruz C, Khan AH, Ahmad B. Antiurolithic evaluation of Cucurbita pepo seeds extract against sodium oxalate-induced renal calculi. 
Pharmacogn Mag. 2020;16(68):174.