Sri Lankan Plants Show Promise in Preventing Kidney Stones
A comprehensive narrative review published in Clinical Phytoscience examines the potential of plant-derived compounds to manage and prevent urolithiasis, a condition characterized by the formation of stones in the urinary system. The study, led by A. G. K. Chamodini and colleagues, focuses specifically on dietary and medicinal plants native to or commonly used in Sri Lanka. The authors argue that while conventional treatments for kidney stones are effective for smaller stones, they often fail to prevent recurrence and may carry significant side effects. By integrating traditional knowledge with modern scientific evidence, the review highlights how specific botanicals can offer a cost-effective alternative to synthetic therapies.
Urolithiasis is a prevalent global health issue, with prevalence rates varying by region, ranging from 1–5% in Asia to up to 13% in North America. The condition disproportionately affects individuals aged 20 to 40, with men being three times more likely to develop urinary stones than women. Most stones are composed of calcium oxalate or calcium phosphate, which account for approximately 75–85% of all cases. The pathophysiology of stone formation involves a complex sequence of physicochemical stages, including urinary supersaturation, nucleation, crystal growth, aggregation, and retention within the kidney due to crystal-cell interactions.
The review identifies several dietary plants with promising anti-urolithiatic properties. Soursop, or Annona muricata, contains alkaloids, flavonoids, and acetogenins that exhibit antioxidant and anti-inflammatory effects. These compounds help reduce oxidative stress and inhibit crystal aggregation in kidney tissues. Additionally, soursop extracts demonstrate diuretic activity, which promotes the clearance of urinary minerals and reduces the risk of crystallization. The efficacy of soursop extracts was found to be concentration-dependent, with higher concentrations showing greater activity in dissolving calcium-based stones.
Sapodilla, known scientifically as Manilkara zapota, offers another avenue for stone management through its litholytic properties. The fruit contains bioactive compounds such as glycine, β-alanine, and hippuric acid, which act as crystallization inhibitors. A key finding from the review is that acid-hydrolyzed sapodilla juice is significantly more effective than fresh juice in dissolving kidney stones. In one study, powdered stones showed a 9.88% solubility after 72 hours in acid-hydrolyzed juice, compared to only 2.64% in fresh juice. This suggests that the preparation method of the plant extract plays a crucial role in enhancing its therapeutic potential.
Garcinia cambogia, a tropical fruit often associated with weight loss, has also shown promise in preventing calcium oxalate stone formation. The review notes that Garcinia cambogia extracts were more effective than citric acid in preventing stone formation and dissolving existing stones in Drosophila kidney tubules. This indicates that the plant may serve as a valuable herbal remedy for managing calcium oxalate kidney stones, although further human trials are needed to confirm these findings.
Pomegranate, or Punica granatum, is rich in polyphenols, alkaloids, and anthocyanins, which have strong free radical scavenging activity. The plant’s phytochemicals are responsible for muscle relaxation in the urinary and biliary tracts, facilitating the removal of stones from the kidney. Pomegranate extracts have been shown to inhibit hyperoxaluria-induced oxidative kidney tubular damage due to their antioxidant properties. In a clinical trial, subjects who consumed 100 mg of pomegranate extract daily for 90 days experienced a reduced incidence of kidney stones, highlighting its potential as a preventive agent.
Green tea, derived from Camellia sinensis, exhibits anti-lithiatic properties primarily due to its high content of catechins, such as epigallocatechin gallate (EGCG). Green tea shows the highest inhibition of stone formation compared to other types of tea, such as oolong and black tea. The polyphenolic compounds in green tea help prevent stone formation by inhibiting the aggregation of free ions in solution. Studies in rat models have demonstrated that green tea significantly reduces oxalate crystal formation and inhibits soluble protein components responsible for stone formation. Furthermore, EGCG has been shown to inhibit calcium oxalate deposition by enhancing superoxide dismutase activity, thereby reducing oxidative stress in the kidneys.
Beyond dietary plants, the review explores medicinal plants used in traditional Sri Lankan medicine. Kalanchoe pinnata, known locally as Akkapana, has been used orally to treat urinary calculi. The extract demonstrated pronounced effectiveness in dissolving calcium oxalate calculi, with approximately 30% of crystals dissolved after five washes. The active components, including organic acids, saponins, and proteins, contribute to this effect by inhibiting crystal growth, aggregation, and retention.
Aegle marmelos, referred to as Beli in Sri Lanka, shows significant potential in preventing urinary calculi disorders. Ethanol and hexane extracts from the plant’s flowers were studied for their ability to inhibit the nucleation, growth, and aggregation of calcium oxalate crystals. The hexane extract at a concentration of 1000 µg/mL displayed the highest inhibition rates for nucleation and aggregation, outperforming the standard drug Cystone. These effects are attributed to phytochemicals such as saponins and anthracene glycosides, which interfere with crystal formation and growth by disrupting mucoproteins and altering ionic composition.
Phyllanthus niruri, known as Pitawakka, has been extensively investigated for its anti-urolithiatic activities. A 42-day animal study demonstrated a considerable reduction in the size and number of calculi after chronic administration of an aqueous extract. Some treated animals even completely eliminated the introduced calcium oxalate crystals. The plant’s protective effects are attributed to its ability to interfere with crystal adhesion to kidney epithelial cells and modulate glycosaminoglycan incorporation into calculi. Clinical studies have also shown that Phyllanthus niruri administration leads to a significant reduction in urinary calcium levels among hypercalciuric patients, thereby decreasing the risk of stone formation.
The review also details the mechanisms by which these phytochemicals exert their effects. Polyphenols act as powerful antioxidants, scavenging reactive oxygen species that promote crystal formation. Flavonoids possess anti-inflammatory and diuretic properties, reducing oxidative stress and inhibiting crystal aggregation. Saponins lower the surface tension of urine, preventing crystal aggregation, while alkaloids regulate calcium and oxalate metabolic pathways. Terpenes enhance urine production, aiding in the flushing out of small crystals and decreasing urinary supersaturation. These multifaceted actions target multiple stages of stone pathogenesis, offering a comprehensive natural strategy for urolithiasis management.
Despite the promising preclinical evidence, the review emphasizes the need for caution regarding safety and toxicity. Some medicinal plants can cause organ-specific toxicities if consumed in excessive or unregulated doses. For instance, Garcinia cambogia has been linked to acute liver injury in case reports, often associated with high doses of hydroxycitric acid. Soursop contains acetogenins that may cause neurotoxic effects after long-term or high consumption. Additionally, herb-drug interactions are a concern, as plant extracts can inhibit cytochrome P450 enzymes, affecting the metabolism of conventional medications. Therefore, standardized formulations and rigorous clinical trials are essential to confirm the efficacy and safety of these plant-based remedies.
The authors conclude that while plant-derived compounds offer a promising alternative for the prevention and management of urolithiasis, further research is crucial to establish clinical efficacy. Most available evidence is derived from in vitro and animal studies, and results cannot be directly extrapolated to human metabolism. Standardization of plant extracts, dose optimization, and toxicological evaluation are essential to ensure safety. By bridging the gap between traditional knowledge and scientific evidence, these botanicals may eventually provide effective and safe therapeutic options for kidney stone prevention and management.
Subject of Research: The potential of Sri Lankan plant-derived compounds in the prevention and management of urolithiasis
Article Title: The role of plant-derived compounds in the management and prevention of urolithiasis: a review of evidence and mechanisms
Article References: Chamodini, A. G. K., Somaratne, G. M., Kariyawasam, K. P., Lakshani, S. G. A., Didulanga, A. G. K. C., Wimalasiri, K. M. S., Bandara, A., & Shiwantha, H. T. L. (2026). The role of plant-derived compounds in the management and prevention of urolithiasis: a review of evidence and mechanisms. Clinical Phytoscience, 12 (1), Article 6. https://doi.org/10.1186/s40816-026-00420-w
Keywords: urolithiasis, kidney stones, phytochemicals, Sri Lankan medicine, calcium oxalate, crystallization inhibition, antioxidants, natural remedies, clinical phytoscience, renal health, role, plant-derived
News Source: Ophelia Keating. (November 7, 2026). Sri Lankan Plants Show Promise in Preventing Kidney Stones. Scienmag.
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