The role of plant-derived compounds in the management and prevention of urolithiasis: a review of evidence and mechanisms

Urolithiasis, the condition of forming stones in the urinary system, is a common health problem worldwide and tends to recur. Pathophysiology includes stages such as supersaturation, nucleation, growth, aggregation, and crystal-cell interactions. Most conventional treatments have disadvantages of failing to prevent recurrence and often with side effects. This review has discussed the therapeutic potential of some Sri Lankan dietary and medicinal plants in the management and prevention of urolithiasis. Dietary plants such as Annona muricata L., Manilkara zapota (L.) P. Royen, Garcinia cambogia (Gaertn.) Desr., Camellia sinensis (L.) Kuntze, and Punica granatum L. exhibit properties that inhibit crystal growth, crystal aggregation, dissolve Calcium Oxalate stones, and promote urinary clearance. Additionally, medicinal plants like Kalanchoe pinnata (Lam.) Pers., Aegle marmelos (L.) Corrêa, Phyllanthus niruri L., Asparagus falcatus L., and Drymoglossum piloselloides (L.) Presl disrupt mucoproteins, alter urinary pH, and enhance stone prevention. Their phytochemicals, including catechins, hydroxycitric acid, polyphenols, flavonoids, saponins, alkaloids, and terpenes, provide antioxidant, anti-inflammatory, diuretic effects, mitigate oxidative stress, and supersaturation. Integrating these botanicals into therapeutic regimens offers a promising, cost-effective alternative to synthetic treatments. However, standardized formulations and clinical trials are essential to confirm efficacy and safety. This review emphasizes combining traditional knowledge with scientific evidence to advance plant-based remedies for urolithiasis.