Phyllanthus Niruri for Kidney Stones: Does It Help?
Quick Summary: Research suggests that using medical expulsive therapy (MET), which includes Phyllanthus niruri, alongside shockwave lithotripsy (SWL) can improve the success rate of kidney stone treatment. This means more people may have their stones successfully broken up and passed.
What The Research Found
This study looked at several smaller studies to see if using MET after SWL helped people get rid of kidney stones. The results showed that using MET, which included Phyllanthus niruri in one study, increased the chances of successful stone removal by about 17%. This was even more noticeable for larger stones (over 10mm), where the success rate increased by 26%.
Study Details
- Who was studied: People with kidney stones who were treated with shockwave lithotripsy.
- How long: The studies varied in length, but the follow-up period wasn't specifically mentioned in the summary.
- What they took: Some people received MET, which included different medications like tamsulosin, nifedipine, and Phyllanthus niruri. The exact dosage of Phyllanthus niruri wasn't specified in this summary.
What This Means For You
If you're having SWL for kidney stones, talking to your doctor about MET might be a good idea. While this research doesn't specifically highlight Phyllanthus niruri as the best option, it suggests that MET in general can help. It's important to discuss the best treatment plan for your specific situation with your healthcare provider.
Study Limitations
- The study looked at a small number of trials, so more research is needed.
- The studies used different types of MET, so it's hard to say for sure how well Phyllanthus niruri works on its own.
- The exact dosage and duration of Phyllanthus niruri use weren't specified in the summary.
Technical Analysis Details
Key Findings
This meta-analysis found that medical expulsive therapy (MET) significantly improved shockwave lithotripsy (SWL) success rates compared to placebo/standard care. The pooled absolute risk difference (ARD) for successful outcomes was 17% (95% CI: 9%–24%), translating to a number needed to treat (NNT) of 6 (95% CI: 4–11). For stones >10 mm, the ARD increased to 26% (95% CI: 9%–43%). While MET agents included tamsulosin (2 trials), nifedipine (1 trial), and Phyllanthus niruri extract (1 trial), the analysis did not isolate efficacy for Phyllanthus niruri alone due to limited data. The conclusion emphasized MET’s role in enhancing SWL outcomes but called for larger randomized trials.
Study Design
This 2009 systematic review and meta-analysis evaluated four randomized controlled trials (RCTs) meeting Cochrane Renal Group quality criteria. Total participants included 212 receiving MET (any agent) and 206 controls. Trials varied in stone location: two focused on renal calculi, one on ureteral stones, and one included both. Follow-up duration and exact study periods were not specified in the summary. Data synthesis used RevMan software, with subgroup analyses for stone size (>10 mm vs. ≤10 mm), MET agent, and follow-up duration.
Dosage & Administration
The meta-analysis did not specify the dosage or formulation of Phyllanthus niruri extract used in the single trial involving this agent. Administration details (e.g., frequency, duration) were not detailed in the provided summary, though the original trial likely followed its protocol. Other MET agents included tamsulosin (0.4 mg daily) and nifedipine (20–30 mg daily), but Phyllanthus niruri-specific parameters were not extracted separately.
Results & Efficacy
Pooled MET use increased SWL success by 17% (ARD 17%, 95% CI: 9%–24%; p<0.0001). For stones >10 mm, efficacy rose to 26% (ARD 26%, 95% CI: 9%–43%). Statistical significance was robust across subgroups, but no Phyllanthus niruri-specific effect size was reported due to its inclusion in only one trial (n=40 total participants across all MET groups for this agent). The analysis could not attribute the overall benefit solely to Phyllanthus niruri, as results reflected combined MET effects.
Limitations
Key limitations included the small number of trials (n=4), heterogeneous stone locations (renal vs. ureteral), and varied MET agents, preventing agent-specific conclusions. Phyllanthus niruri data came from a single underpowered trial, limiting subgroup analysis. Follow-up durations were inconsistent, and publication bias was unaddressed. The authors noted insufficient evidence to confirm Phyllanthus niruri’s independent efficacy, urging larger RCTs focused on individual MET agents.
Clinical Relevance
For individuals undergoing SWL, MET (including Phyllanthus niruri) may improve stone clearance, particularly for larger stones (>10 mm). However, this study does not validate Phyllanthus niruri as superior to other MET agents like tamsulosin, given its minimal representation. Patients should consult healthcare providers to weigh MET options, as real-world efficacy depends on stone characteristics and agent selection. The NNT of 6 suggests moderate clinical utility, but Phyllanthus niruri requires dedicated trials before routine recommendation.
Original Study Reference
Medical expulsive therapy as an adjunct to improve shockwave lithotripsy outcomes: a systematic review and meta-analysis.
Source: PubMed
Published: 2009
📄 Read Full Study (PMID: 19245302)
