Antilithiatic Effect of TribulusTerrestris

Abstract

Urolithiasis is the third most common disorder of the urinary tract affecting 2 20% population worldwide. Urinary calculi are caused by various etiological factors with a worldwide increasing incidence and prevalence causing substantial morbidity and economic burden. Archaeological findings give profound evidence that humans have suffered from kidney stones for centuries. Epidemiological data have shown that calcareous stones are found in a majority of kidney stones majorly composed of calcium oxalate and calcium phosphate. Calcium oxalate stones are found in two different varieties, calcium oxalate monohydrate or Whewellite, and calcium oxalate dihydrate or Weddellite. Calcium oxalate monohydrate, the thermodynamically most stable form, is observed more frequently in clinical stones than calcium oxalate dihydrate and it has a greater affinity for renal tubular cells, thus responsible for the formation of stones in kidney. The formation of such concretion encompasses several physiochemical events beginning with crystal nucleation, growth, aggregation and ending by retention within urinary tract. The mechanisms governing the induction of all these processes remain speculative. Surgical operation, lithotripsy and local calculus disruption using high-power laser are widely used to remove calculi along with dietary interventions and therapies like thiazide diuretics and alkali-citrate to prevent recurrence but scientific evidence for their efficacy is less convincing.