ANTILITHIATIC ACTIVITY OF LEAF EXTRACT OF CITRUS MEDICA ON SODIUM OXALATE UROLITHIAIS–IN-VITRO AND IN-VIVO EVALUATION

Urolithiasis is a common urological disorder responsible for serious human affliction and cost to society with a high recurrence rate. The aim of the present study was to systematically evaluate the leaf extract of Citrus medica using suitable in-vitro and in-vivo models to provide scientific evidence for its antilithiatic activity. Cystone has been suggested to be beneficial in urolithiasis, as it corrects the crystalloid, colloid stability. It is evaluated that flavonoids, triterpenoids and saponins from different plants resulted in the antilithiatic activity.  To explore the effect of Citrus medica on sodium oxalate crystallization, in-vitro assays like crystal nucleation and aggregation were performed. The biochemical parameters like calcium, oxalate, magnesium, phosphate, sodium, and potassium were evaluated in urine, serum, and kidney homogenates. Histopathological studies were also done to confirm the biochemical findings. In-vitro experiments with Citrus medica showed concentration-dependent inhibition of sodium oxalate nucleation and aggregation. In the in-vivo model, Citrus medica reduced both sodium and oxalate supersaturation in urine, serum, and deposition in the kidney. The biochemical results were supported by histopathological studies. The findings of the present study suggest that Citrus medica has the ability to prevent nucleation and aggregation growth of sodium oxalate crystals. Citrus medica has a better preventive effect on sodium oxalate stone formation, indicating its strong potential to develop as a therapeutic option to prevent recurrence of urolithiasis.