A Review on Medicinal Plants Used in Treatment of Kidney Stone

Kidney  stones  are  a  health  problem  that  affects  people  of  all  genders,  races,  and  ages.  It  is  thought  that  this  condition  is  becoming  more  common  in  many  parts  of  the  world.  Along  with  the  effects  of  global  warming,  how  people  eat  may  be  a  big  reason  for  this  increase.  About  12%  of  people  around  the  world  will  develop  kidney  stones  at  some  point  in  their  lives.  Having  kidney  stones  can  increase  the  chances  of  getting  chronic  kidney  disease  by  60%  and  end-stage  kidney  disease  by  40%.  It  has  also  been  linked  to  a  type  of  kidney  cancer  called  papillary  renal  cell  carcinoma.
In  recent  times,  there  has  been  more  interest  in  using  herbal  products  because  of  the  high  cost  and  side  effects  of  surgeries  and  medical  procedures.
For  a  long  time,  people  and  animals  have  used  medicinal  plants  as  a  main  source  of  food  and  medicine.  Today,  many  researchers  are  studying  natural  resources  like  herbs  and  old  techniques  used  by  people  like  Ibn  Sina  .  Medicinal  plants  can  help  ease  the  pain  from  kidney  stones  and  stop  the  formation  of  new  ones.  They  can  also  help  remove  stones  from  the  kidneys.  These  plants  are  used  to  treat  different  types  of  kidney  stones,  including  calcium  oxalate,  uric  acid,  struvite,  and  cysteine.  The  use  of  herbal  medicine  is  part  of  the  development  of  modern  society .

Causes of Kidney Stone

Kidney stones happen when the body doesn't make enough urine to wash away minerals, which then turn into crystals. Some main reasons for this include not drinking enough water, eating too much salt, being overweight, and having certain health issues like gout, inflammatory bowel disease, or urinary tract infections. Also, eating too much meat, foods high in oxalates, and some types of supplements can lead to kidney stones.

• Dehydration
• High sodium diet
• Obesity
• Dietary excess
• Gout
• UTI’s
• Diabetes

Symptoms  of  Kidney  Stone

A  kidney  stone  often  doesn't  cause  any  pain  until  it  moves  inside  the  kidney  or  travels  into  one  of  the  ureters.  The  ureters  are  the  tubes  that  carry  urine  from  the  kidneys  to  the  bladder. If a kidney stone gets stuck in a ureter, it can block the urine flow.
This can make the kidney swell and cause the ureter to tighten. This can be really painful. When this happens, you might feel:

• A severe, sudden pain on the side and back, just below the ribs.
• Pain that moves to the lower belly and groin area.
• Pain that comes in waves and changes in how strong it feels.
• A burning or painful feeling when you urinate.
• Urine that looks pink, red, or brown.
• Urine that is cloudy or has a bad smell.
• A strong need to urinate, going more often than usual, or urinating small amounts.
• A stomachache or feeling sick and throwing up.
• Fever and shivering if there's an infection.

The pain from a kidney stone can change as the stone moves through your urinary system.
For example, the pain may move to a different part of your body or get worse.

Pathophysiology of Kidney Stone :

Fig. Pathophysiology of Kidney Stone

Stone growth starts with the formation of crystals in supersaturated urine which then adhere to the urothelium, thus creating the nidus for subsequent stone growth. The biological processes that anchor crystals to the urothelium are incompletely understood. Many, but not all, calcium oxalate stones develop on Randall's plaques which are composed of calcium phosphate (= hydroxyapatite) crystals. These grow to erode the urothelium, forming a nucleus for calcium oxalate deposition.

More recent ideas look at how certain molecules on the surface of cells can either help or stop crystals from sticking. When the lining of the urinary tract gets damaged and heals after a stone forms, these molecules may appear more on the cell surface, making it easier for new crystals to stick. This is why it's said that a stones beget stones because there might be a leftover piece of a stone that can help form new ones, and/or these molecules may increase to make crystal sticking more likely. Preventing stones involves finding and reducing the factors that lead to crystal formation.

Some things, like not producing enough urine, having less citrate in the urine, or having urine that is too acidic, can help this happen. Also, stones can form around things like organic material.

Stages of Kidney Stones :

• Supersaturation : The first step in making a kidney stone is called the supersaturation stage. During this time, the amount of minerals like calcium, oxalate, and uric acid in the urine becomes too high. These minerals dissolve in the urine, but when there's too much, they can't stay dissolved anymore. This makes the urine unstable, and the extra minerals start to come out of the liquid, forming tiny crystals. This is the beginning of a kidney stone forming. Supersaturation occurs due to a high concentration of stone-forming substances and/or low urine volume (dehydration), the concentration of these solutes becomes so high that if more were to dissolve, they would immediately crystallize out of the solution.
• Nucleation : The first step in forming a kidney stone is called nucleation, where ions in the urine start to come together to make a small, stable starting point for a crystal. This can happen in two main ways: one is when ions join on their own in a very concentrated urine, and the other is when they stick to existing particles like cells, proteins, or other tiny crystals. Once this small starting point forms, more ions can attach to it, causing the crystal to grow larger.
• Crystal growth : The crystal growth stage of kidney stone formation occurs after supersaturation and nucleation, where individual crystals combine and increase in size by adding more mineral components to their surface.
  This growth is a slow process driven by the aggregation of smaller crystals or secondary nucleation on the surface of an existing crystal. Factors like urinary pH, promoters, and inhibitors influence the rate of this growth.
• Crystal retention : The crystal retention stage happens when tiny crystals formed in urine get stuck in the kidney or the tubes that collect urine. Once they stay in place, they can't be washed out and start to get bigger. These crystals might stick together or attach to the walls of the kidney tubes. This can happen because of certain biological factors or specific materials in the body, like Randall's plaques. This stage is important because it's the first step that leads to stones becoming large enough to cause problems. It's not just about the crystals being passed in urine, but also how they stick in the kidney.
• Obstruction and clinical symptoms : The symptoms a person has from a kidney stone mostly depend on if the stone is blocking the urinary tract and where the blockage is. If the stone is small and not causing a blockage, it might not cause any pain or problems. But if the stone is bigger or if it moves, it can lead to very severe pain and other serious health issues.

Fig. Stages of Kidney Stone

Plants used in treatment of kidney stone :