Introduction:
Persistent nephrolithiasis post Extracorporeal Shockwave Lithotripsy (ESWL) usually treated with ureteroscopy. However, not all patients opted for this invasive approach.
In vitro studies have shown the benefit of Orthosiphon and Sericocalyx for nephfrolithiasis. However, there is still lack of data regarding the effectiveness and safety in real world setting. Regardless of that, many patients have been consuming nutraceutical of these substances in treating nephrolithiasis in our setting. This study aims to address this issue.
Methods:
Medical record data from one hospital (from december 2019 to june 2024) were pooled for retrospective analysis. Patients with age ≥17 years old, confirmed diagnosis of nephrolithiasis (by ultrasonography/USG or computerized tomography scan/CT-scan), consuming nutraceutical containing Orthosiphon and Sericocalyx at least two months, and has undergone ESWL were included. Patients with advanced chronic kidney disease, diabetes, heart failure, liver disease, congenital urinary tract system defect, prostate hypertrophy, consuming tamsulosin, and incomplete follow-up records were excluded. Primary outcome is the complete dissolution of nephrolithiasis by imaging data.
Results:
Total of 361 patients was screened, but only 197 (106 male, 91 female) met the inclusion. Eighty patients were hyperuricemia (48 male and 32 female). Most of the patients (135 patients) have a diameter of stone (the largest) ≤1cm, and 62 patients have stone diameter of >1 cm. All patients consumed the nutraceutical containing Orthosiphon 162.64 mg, and Sericocalyx 162.64 mg for three times a day. Mean age was 39.2 ±14.9. Mean duration of therapy was 8.15 ±3.64 months.
Primary outcome occurred in 76.1% (150/197) patients while 23.9% (47/197) did not. Ninety-seven percent (131/135) patients with stone diameter of ≤1cm achieved stone dissolution, and only 3% (4/135) failed. On the other hand, only 30.6% (19/62) patients with stone diameter of >1cm achieve stone dissolution. Multilogistic regression analysis showed that diameter of the stone affects the outcome (p=0.011). Contrarily, the age, sex, hyperuricemia status, amount of stone, and duration of treatment did not (p>0.05). Subanalysis based on the stone diameter (≤1cm vs. >1cm) indicates that smaller diameter favors the odds for stone dissolution (Odds ratio 3.17; 95% Confidence Interval 2.18-4.61; p<0.05).
In terms of safety, there were no reports of serious side effects that caused discontinuation of therapy as well as no significant changes in both liver and kidney function test during the study.
Conclusions:
This study suggests that consumption of nutraceutical containing Orthosiphon and Sericocalyx may benefit patients with persistent nephrolithiasis post ESWL especially for stone diameter of ≤1 cm. Due to the limitations of retrospective analysis, this result may require further confirmation in a randomized controlled study.
I have no potential conflict of interest to disclose.
I did not use generative AI and AI-assisted technologies in the writing process.