Phyllanthus Niruri for Kidney Stones? Research Says...

Key Findings

The study found no statistically significant effect of Phyllanthus niruri on calciuria (urinary calcium excretion) in hypercalciuric patients after three months of treatment. This result emerged from a subgroup analysis within a larger Cochrane review of dietary interventions for idiopathic hypercalciuria. Unlike other interventions tested in the review (e.g., low-salt/normal-calcium diets), P. niruri showed no measurable benefit for the primary outcome of reducing urinary calcium levels, a key factor in kidney stone formation.

Study Design

This analysis focuses exclusively on the Phyllanthus niruri component of the Cochrane review. It was a randomized controlled trial (RCT) subgroup involving 20 adult participants diagnosed with idiopathic hypercalciuria. The intervention duration was three months, with outcomes measured against an unspecified control group (placebo, no intervention, or alternative diet per the review's inclusion criteria). The review noted high risks of bias across all included studies due to inadequate reporting of randomization methods and blinding procedures, though objective outcomes like calciuria were deemed less susceptible to bias.

Dosage & Administration

The Cochrane review abstract did not specify the dosage, formulation (e.g., extract, whole plant), or administration method (e.g., oral capsule, tea) of Phyllanthus niruri. It only described the intervention as "plant substrate intake," indicating insufficient methodological detail was reported in the original study or the review.

Results & Efficacy

P. niruri demonstrated no significant reduction in calciuria (urinary calcium excretion). The review explicitly states: "there was no significant effect on calciuria levels occurred after three months of treatment." No quantitative data (e.g., mean differences, confidence intervals, p-values) were provided for this specific intervention in the abstract. This contrasts with other interventions in the review (e.g., low-salt/normal-calcium diets showing MD -45.00 mg/d urinary calcium reduction, 95% CI -74.83 to -15.17), highlighting the lack of efficacy for P. niruri under the tested conditions.

Limitations

Critical limitations include the extremely small sample size (n=20), which severely limits statistical power to detect clinically meaningful effects. The absence of dosage/administration details prevents replication or interpretation of bioactive compound exposure. The Cochrane review identified high risk of bias across all included studies due to poor reporting of randomization and allocation concealment. Additionally, the subgroup analysis design increases the risk of Type II errors (failing to detect a true effect), and no data on adherence, safety, or secondary outcomes (e.g., stone recurrence) were reported for P. niruri.

Clinical Relevance

For individuals with idiopathic hypercalciuria, this study provides no evidence supporting P. niruri supplementation to reduce urinary calcium excretion or prevent kidney stones. The negative result—coupled with the study's methodological weaknesses—suggests current evidence does not justify its use for this indication. Clinicians and patients should prioritize interventions with stronger evidence, such as long-term adherence to normal-calcium/low-salt/low-protein diets (which reduced stone recurrence by 23% in the same review). Further rigorous RCTs with adequate power, precise dosing, and clinically relevant endpoints are essential before P. niruri can be recommended.