From the Guidelines
Chanca Piedra (Phyllanthus niruri) leaf supplements are not recommended for the treatment of kidney stones due to limited evidence and potential safety concerns. The available evidence does not support the use of Chanca Piedra for the prevention or treatment of kidney stones, and the American College of Physicians (ACP) guideline recommends increased fluid intake and pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol to prevent recurrent nephrolithiasis 1, 2, 3, 4.
Key Considerations
- The ACP guideline recommends management with increased fluid intake spread throughout the day to achieve at least 2 L of urine per day to prevent recurrent nephrolithiasis 1.
- Pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol is recommended to prevent recurrent nephrolithiasis in patients with active disease in which increased fluid intake fails to reduce the formation of stones 2.
- The evidence for the effectiveness of Chanca Piedra in treating kidney stones is limited and of low quality, and safety concerns exist, including potential interactions with medications like blood thinners and diabetes drugs.
- Pregnant or nursing women, children, and those with certain medical conditions should avoid using Chanca Piedra supplements.
Potential Risks and Benefits
- Potential benefits of Chanca Piedra include anti-inflammatory and hepatoprotective properties, but these are not well-established and may not outweigh the potential risks.
- Potential risks include digestive upset, hypoglycemia, and interactions with medications.
- The quality and potency of Chanca Piedra supplements can vary significantly between products, and patients should consult with a healthcare provider before starting treatment.
Clinical Implications
- Clinicians should recommend evidence-based treatments for kidney stones, such as increased fluid intake and pharmacologic monotherapy with a thiazide diuretic, citrate, or allopurinol.
- Patients should be advised of the potential risks and benefits of Chanca Piedra supplements and should consult with a healthcare provider before starting treatment.
- Further research is needed to establish the safety and efficacy of Chanca Piedra supplements for the treatment of kidney stones.
From the Research
Efficacy of Chanca Piedra (Phyllanthus niruri) Leaves Supplement
- The study 5 suggests that Phyllanthus niruri may interfere with calcium oxalate crystallization, reduce hyperoxaluria and hyperuricosuria, and increase the efficacy of shock wave lithotripsy due to reduced crystallization, without significant adverse effects.
- Another study 6 found that Phyllanthus niruri has been shown to interfere with many stages of stone formation, reducing crystals aggregation, modifying their structure and composition as well as altering the interaction of the crystals with tubular cells leading to reduced subsequent endocytosis.
- The herbal extract of Phyllanthus niruri was also found to increase the rate of nucleation and decrease the rate of growth significantly in synthetic urine, suggesting its potential to serve as an inhibitor of calcium oxalate stone formation 7.
Safety of Chanca Piedra (Phyllanthus niruri) Leaves Supplement
- The study 5 mentions that the findings suggest that Phyllanthus niruri has no significant adverse effects.
- Another study 6 states that no adverse renal, cardiovascular, neurological or toxic effects have been detected in either of the studies.
- However, it is important to note that the FDA classifies herbal preparations as food supplements and does not rigorously define safe practices, and scientific evidence related to herbal supplements is limited 8.
- More research is required to fully understand the potential of Phyllanthus niruri in drug discovery given the limited ethnobotanical studies and data available for most species with regards to identification on bioactive components, pharmacological mechanisms, and the scarce number of clinical studies 9.