Kidney Stones

S B Erickson et al. (2011) · Phytomedicine : international journal of phytotherapy and phytopharmacology

This small randomized trial with 10 people explored whether Cystone, an Ayurvedic herbal tablet sold for kidney stones, changes the urine chemistry that drives stone formation or reduces the amount of stone in the kidneys. Kidney stones are painful and often recur, and the available prevention options (diet changes and medicines such as thiazides, potassium citrate and allopurinol) have drawbacks. Cystone is a blend of seven plants plus purified Shilajeet and a mineral preparation (bhasma), traditionally used for urinary problems, but the authors say earlier studies of it were small and poorly controlled. Ten adults from the Mayo Stone Clinic who repeatedly formed calcium oxalate stones took two Cystone tablets twice a day, or matching placebo, for six weeks each in a crossover design, switching after a one-week break. All then took Cystone openly for another 48 weeks. Urine collected over 24 hours measured how saturated it was with stone-forming minerals. CT scans at the start and after a year, scored with the same method used for heart-artery calcium, measured stone volume, and a radiologist reviewed them without knowing the timing. Cystone did not change urinary measurements in the short term (6 weeks) or the long term (52 weeks). Average stone burden per kidney actually rose from 93 to 114 cubic millimetres (P = 0.07) and from 108 to 136 on the Agatston scale (P = 0.10), neither statistically significant. The radiologist counted 8 kidneys with more stone, 8 unchanged and 2 with less, and four kidneys passed stones spontaneously. No participant described side effects they attributed to Cystone. The authors conclude the trial does not support Cystone for preventing calcium oxalate stones, while noting the sample was tiny, participants had stones that standard treatment had not controlled, and some factors that inhibit stone formation were not measured. They say a longer study with more patients would be needed to look at stone passage or other stone types.

Ying Cao et al. (2025) · QJM : monthly journal of the Association of Physicians

This randomized trial with 84 emergency department patients explored whether acupuncture started right away, before a diagnosis is confirmed, eases the pain of suspected renal colic, the sudden, severe cramping pain in the back or abdomen that usually comes from a kidney or urinary stone. Imaging to confirm a stone takes time while patients are in extreme pain, and the authors note that the usual painkillers have drawbacks: anti-inflammatory drugs can raise heart risk with higher doses and longer use, and opioids cause side effects including nausea, drowsiness and dependence concerns. Acupuncture, a traditional Chinese medicine technique that places thin needles at specific body points, had already been reported by this group to reduce pain in confirmed cases. Adults aged 18 to 80 with one-sided colicky pain and tenderness over the kidney area, and pain of at least 4 on a 0 to 10 scale, were treated at a Beijing hospital emergency department. Half received needles in the back of both hands at Yaotongdian, a point the authors use for lumbar pain, with the needles lifted and rotated until a soreness or heaviness sensation appeared and then left in for 30 minutes. The other half had very shallow needling with tiny short needles at spots that are not acupuncture points, with no manipulation. Ten minutes after needling, 64.3% of the acupuncture group (27 of 42) had at least halved their pain, versus 16.7% of the sham group (7 of 42), a 47.6 percentage point gap (P < 0.01, so chance is very unlikely to explain it). By 30 minutes the figures were 85.7% versus 31.0%. Average pain scores at 10 minutes were 3.38 versus 6.00. Fewer acupuncture patients needed an analgesic injection by 30 minutes (33.3% vs 59.5%; P = 0.03) and satisfaction scores were higher (4.69 vs 3.69). Patients, outcome assessors and statisticians did not know the group, and patients guessed their group at similar rates, so the blinding held. Surgery and return visits did not differ between groups, and each group had one adverse event (bleeding with acupuncture; nausea and vomiting with sham). The authors suggest that early acupuncture is a safe option for pain relief while a diagnosis is awaited and that it did not appear to interfere with later care. The authors also note that a single acupuncture point may give limited improvement in critically ill patients. They state plainly that the study was done at one center with experienced acupuncturists, included only 3 acupuncture-group patients who turned out not to have a urinary stone, and did not analyze results by stone size. They call for multicenter confirmation.

Jian-Feng Tu et al. (2022) · JAMA network open

This randomized trial with 80 emergency department patients explored whether adding acupuncture to a standard painkiller injection brings faster relief from renal colic, the severe cramping flank pain that occurs when a kidney stone blocks or moves through the urinary tract. Renal colic is described by the authors as one of the worst types of pain, and the guideline first-choice drugs, nonsteroidal anti-inflammatory medicines such as diclofenac, take time to work: in an earlier study, 37.5% of patients still had moderate or severe pain 15 minutes after an injection. Acupuncture, a traditional Chinese medicine technique that inserts thin needles at specific body points, had shown quick pain reduction in other settings. Adults aged 18 to 75 with stone-related renal colic and pain of at least 4 out of 10 on a visual analog scale (a line on which patients mark their pain) were treated at a Beijing hospital emergency department in 2020. Everyone received a 50 mg diclofenac injection into the muscle. Half then had 30 minutes of needling at Yaotongdian, a point on the back of each hand, with the needles twisted and lifted until a soreness or heaviness sensation (called De qi) appeared. The other half had shallow needle pricks at forearm spots that are not acupuncture points. Ten minutes after needling, 77.5% of the acupuncture group (31 of 40) had at least halved their pain score, compared with 10.0% of the sham group (4 of 40), a gap of 67.5 percentage points (P < .001, so chance is very unlikely to explain it). Average pain fell to 3.0 versus 5.9 out of 10. Acupuncture also led at 0, 5, 15, 20 and 30 minutes (97.5% vs 80.0% at 30 minutes; P = .03). Patients, assessors and the statistician did not know the group, and patients guessed their group about equally often in both arms (P = .48). The advantage faded as the injection took effect: by 45 and 60 minutes both groups had about 92% to 98% responding (P = .62), and only 1 patient needed stronger rescue medication. No adverse events were recorded. The authors suggest acupuncture may serve as an optional add-on for faster relief, since it uses a single point and needs no individual diagnosis. They attribute the absence of a rescue-medication difference to a possible ceiling effect from the diclofenac. They note limitations plainly: one hospital, treatment given after diagnostic imaging, experienced acupuncturists who could not be blinded, and no follow-up of pain beyond 60 minutes or analysis by stone size. They plan to study acupuncture before imaging.

Dan Wang et al. (2026) · JAMA network open

This phase 3 randomized trial of 606 adults in China explored whether Guang Jing, a capsule made from the total flavonoids (plant pigment compounds with antioxidant activity) of the traditional Chinese herb Desmodium styracifolium, helps ureteral stones pass out of the body. A ureteral stone is a mineral deposit lodged in the tube that carries urine from the kidney to the bladder. Treatment that encourages passage is called medical expulsive therapy, and the authors note that alpha-blocker drugs, the guideline option, have shown mixed results in large trials. No oral medicine is currently approved for urolithiasis, and Guang Jing is already approved in China for ureteral stones. Participants were adults aged 18 to 70 with a newly diagnosed ureteral stone of 5 to 10 mm and a traditional Chinese medicine pattern called damp-heat accumulation (urethral burning, lower back pain or blood in the urine). At 34 hospitals, three of every four received 3 capsules (0.6 g) of Guang Jing three times daily for 28 days, and the rest received identical placebo capsules. Neither participants nor investigators knew who received which. Passage was confirmed by CT scan on day 28, read by blinded investigators. By day 28, 44.6% of the Guang Jing group (204 of 457) had passed their stone versus 33.8% of the placebo group (50 of 148). That is a 10.9 percentage point difference (relative risk 1.32, so passage was about one-third more likely; P = .03). At day 14 the groups did not differ significantly (29.1% vs 22.3%; P = .14), and stone movement distance was almost identical (29.5 vs 29.7 mm). Among those with 0.6 to 1.0 cm stones, passage was 37.2% vs 24.4% (a larger gap in the bigger stones), and 66.2% of Guang Jing participants with distal stones, the lower part of the ureter near the bladder, passed them. Adverse events were similar (19.3% vs 18.2%, meaning side effects were about as common with the capsule as with placebo), with no medication-related serious events. The authors describe the absolute benefit as modest, since 55.4% of the Guang Jing group did not pass a stone by day 28. The trial enrolled a fairly uniform group, mostly from southern China, and the subgroup results were exploratory. The authors state that this homogeneous population limits how far the findings generalize, and that CT slice thickness may have missed small differences in stone movement. They plan further trials in Europe and North America and call for studies to identify who benefits most and to establish how the extract works in humans.

Ramin Ansari et al. (2024) · Journal of research in medical sciences : the official journal of Isfahan University of Medical Sciences

This randomized, double-blind, placebo-controlled trial with 51 adults explored whether Mofatet powder — a six-herb formulation from Traditional Persian Medicine (TPM) — could shrink existing calcium kidney stones, not just prevent new ones. TPM is a centuries-old medical system, described in texts by Rhazes and Avicenna, that combines specific plant combinations for named conditions; Mofatet powder is one such combination, traditionally taken as a boiled decoction of six seeds and fruits in equal parts. Kidney stones affect up to 15% of people worldwide, and most current drugs only stop new stones from forming rather than dissolving the ones already there. Researchers recruited 51 adults (mean age about 50) with confirmed calcium stones at least 5mm across, in Shiraz, Iran. Twenty-six received capsules of a freeze-dried extract of the six-herb blend (cucumber seed, pumpkin seed, celery seed, fennel seed, anise seed, and tribulus fruit) twice daily for 5 weeks; 25 received a matching placebo. Stone size was tracked by ultrasound imaging, alongside urine and blood chemistry. The herbal group's stones shrank by 60.73% on average, compared to just 2.52% in the placebo group (a highly significant difference, p<0.001), and two people's stones disappeared entirely versus none on placebo. Urinary magnesium — a mineral that normally helps stop stone-forming crystals from growing — rose by nearly 58% in the herbal group, while urinary calcium (a stone-forming risk factor) dropped. Urine also became less concentrated (lower specific gravity), which reduces the conditions that let crystals form in the first place. Importantly, kidney and liver function tests (BUN, creatinine, AST, ALT) showed no meaningful changes in either group, and no significant side effects were reported over the five weeks — though the herbal group did show a rise in blood calcium that the researchers did not fully explain. These findings suggest this traditional formulation could be a safe, complementary option for people managing calcium kidney stones, likely by making urine less prone to crystal formation rather than by dissolving stones directly. The trial was conducted at a single center with a modest number of participants over a short 5-week window, so the results need confirming in larger, longer studies before this becomes a routine recommendation.