Antilithogenic Efficacy Of An Innovative Beverage Hydrozitla: In Vitro And In Vivo Studies

Abstract

Urinary stone disease is a common urologic disease worldwide, and it is highly recurrent. Calcium oxalate (CaOx) stone is the most common type of urinary stones. The main causes of urinary stone formation include inadequate water intake, low urinary citrate excretion and increased oxidative stress. At the present day, potassium citrate is a drug of choice for preventing stone formation and recurrence. We developed a new regimen for preventing urinary stone formation, called HydroZitLa. It was in a form of concentrate in pouch. For consumption, water was added up to 500 mL and shake well before drink. Therefore, drinking of HydroZitLa ensured that patients gained more water intake. The active antilithogenic ingredients of HydroZitLa were citrate (16 mEq/pouch) and natural antioxidants from Thai medicinal plants. In vitro study found that HydroZitLa significantly inhibited CaOx crystal aggregation. HydroZitLa had antioxidative function to reduce oxidative stress in HK-2 cells treated with CaOx and H2O2. In vivo experiment was performed to investigate the stone inhibitory effect of HydroZitLa in nephrolithic rats was induced by ethylene glycol (EG). Twenty male Wistar rats were randomly divided into four groups; control (n=2), EG (n=6), EG+HydroZitLa (n=6) and EG+Uralyt-U (n=6). The results showed that CaOx crystal deposits in the kidneys of EG+HydroZitLa and EG+Uralyt-U groups were significantly lower than the EG group. Inflammation and oxidative stress in the kidney tissues of EG group were evidently higher than the EG+HydroZitLa and EG+Uralyt-U groups. Urinary citrate excretion in the EG+HydroZitLa and EG+Uralyt-U groups were increased compared to the EG group. In conclusion, the present study demonstrated that HydroZitLa and Uralyt-U drug exhibited the ability to inhibit CaOx crystal deposition and reduce oxidative stress in the kidneys of EG-induced nephrolithic rats. This innovative HydroZitLa product could be an effective therapeutic regimen for the treatment of urinary stone disease. The pre-clinical antilithogenic efficacy of HydroZitLa was comparable to the potassium citrate drug, Uralyt-U. Clinical efficacy of HydroZitLa will be further tested in the clinical trials.