Comparative evaluation of Thai folk herbal recipes and potassium citrate in rats with calcium oxalate urolithiasis

Abstract

Urolithiasis is a common urological disease in Thailand, and traditional herbal recipes remain widely used in community practice. This study evaluated the efficacy and safety of three recipes—Hibiscus, Orthosiphon, and Coix—compared with potassium citrate (K-Citrate) in a rat model of calcium oxalate urolithiasis. Forty-eight male Wistar rats were randomized into six groups (control, urolithiasis, K-Citrate, Hibiscus, Orthosiphon, Coix). Urolithiasis was induced by intraperitoneal ethylene glycol and vitamin D for 5 days, followed by 2 weeks of treatment. The Coix recipe markedly reduced renal calcium oxalate deposition (grade 0; p < 0.001), with efficacy similar to K-Citrate, though urinary crystal counts at week 2 were not lower than in untreated rats, likely reflecting reduced tubular crystal burden rather than obstruction. Hibiscus treatment provided moderate protection (grade 1; p < 0.001) but showed higher urinary crystal counts at week 2, possibly due to enhanced clearance. Orthosiphon failed to reduce stone severity (grade 5; p = 0.087), despite transient diuretic effects. All herbal treatments maintained normal ALT, AST, and creatinine levels, indicating a favorable safety profile. These findings suggest that Coix and Hibiscus recipes have potential as safe, culturally rooted, and environmentally sustainable options for urolithiasis management, though further studies are required to standardize dosing, identify active compounds, and assess urinary biochemical effects before clinical application.