| Abstract|| |
To investigate the effect of parsley leaf tea on urine composition and the inhibitors of urinary tract stones formation, we studied 20 healthy volunteers who were divided into two groups: the first group of 10 subjects drank daily 1,200 mL of parsley leaf tea for 2 weeks, while the second group drank at least 1,200 mL daily of bottled water for the same period. This was followed by a 2-week "washout" period before the two groups were crossed over for another 2 weeks. During the experimental phase, 24-h urine samples were collected at baseline, on day 14, and at the end of the 6-week period and different urinary parameters were measured and analyzed statistically. We found no significant difference in the urine volume, pH, sodium, potassium, chloride, urea, creatinine, phosphorus, magnesium, uric acid, cystine, or citric acid. Further research is needed to evaluate the effects of parsley leaf tea on urinary parameters in healthy and stone-forming patients.
|How to cite this article:|
Alyami FA, Rabah DM. Effect of drinking parsley leaf tea on urinary composition and urinary stones' risk factors. Saudi J Kidney Dis Transpl 2011;22:511-4
|How to cite this URL:|
Alyami FA, Rabah DM. Effect of drinking parsley leaf tea on urinary composition and urinary stones' risk factors. Saudi J Kidney Dis Transpl [serial online] 2011 [cited 2021 May 5];22:511-4. Available from: https://www.sjkdt.org/text.asp?2011/22/3/511/80488
| Introduction|| |
Urinary tract stones are a common worldwide healthcare problem with high prevalence (20%) in Saudi Arabia.  The treatment of urinary tract stones has dramatically changed over the last 20 years. Today, the vast majority of stone diseases can be treated effectively with minimal surgical intervention such as shock wave lithotripsy (SWL) and endourological techniques, and sometimes can even be treated conservatively. However, a major problem is the high recurrence rate even after surgery or SWL. , The high prevalence and high recurrence rates underscore the importance of a preventive program.
The development of stones in the urinary tract is a complex, multifactorial process.  There are many theories that explain the pathogenesis of stone formation, for example, the supersaturation theory and the inhibitors theory. Supersaturation occurs when there is an overabundance of solute in a solution.  Although urolithiasis is a multifactorial disease, nutrition, especially fluid intake, is one of the most important factors involved. ,
Many of our patients have traditionally used parsley leaf tea for the treatment and prevention of urolithiasis. This has been based largely on hearsay, the advice of traditional healers or even on the advice of medical doctors, and is similar to the use of cranberry juice by lay people in western cultures. ,,,, Our aim in this study is to investigate the effect of parsley leaf tea on urine composition, and the risk factors of urinary tract stone formation.
| Subjects and Methods|| |
The subjects included had no previous history of urolithiasis, renal insufficiency, recurrent or active urinary tract infections, acid-base disorders, diabetes, liver diseases, gastrointestinal diseases, primary gout, or any debilitating chronic illness. In a randomized crossover interventional trial, we distributed our volunteers into two groups (A and B) using sealed enve-lopes. Each group contained 10 subjects.
During the first 2 weeks of the trial, group A drank a daily volume of 1,200 mL of parsley tea in addition to at least 1,000 mL of liquid of their choice per day, while group B drank at least 1,200 mL of bottled water (we used same type of bottled water for all subjects) in addition to at least 1,000 mL of liquid of their choice per day. We instructed the volunteers to boil 20 mg of parsley leaf in 1,200 mL of bottled water at 100°C. After a "washout period" of 2 weeks, both groups changed to the other treatment.
Urine samples were taken from the container to test for urine pH, blood, WBCs and nitrates. If there was any evidence of UTI, we excluded the sample.
For urinary measurements, 24-h urine samples were collected by each subject at baseline ("control") and at the end of each drinking protocol (14 days). Urinary pH and volume were routinely measured for each sample. Urinary sodium, potassium, chloride, urea, creatinine, calcium, phosphorus, magnesium and uric acid were measured using commercially available assay kits and a Dade Dimension® clinical chemistry system. Urinary oxalate was measured using a colorimetric method. Urinary cystine was measured using the Biochrom 20 Plus Amino Acid Analyser with a continuous flow chromatography method. Urinary citric acid was measured using a photometric method.
| Statistical Analysis|| |
The average of the two urine collections from each phase was used for comparison by using matched paired t tests. Analyses were performed using SPSS® statistical software version 12. Statistical significance was assumed for P values less than 0.05. Results in the table were expressed as the mean and its standard error.
| Results|| |
All investigations were carried out on 20 healthy volunteers, aged from 22 to 53 (mean = 39.8, SD = 8.237) years, with body mass index from 19.48 to 42.45 (mean 27.33, SD 5.523).
The mean urinary variables and the computed risk indices are shown in [Table 1]. There was no significant change in the urine volume, pH, sodium, potassium, chloride, urea, creatinine, phosphorus, magnesium, uric acid, cystine or citric acid.
|Table 1: The comparison of the measured parameters in the study subgroups. The differences were not statistically significant. Standard errors given in brackets.|
Click here to view
Parsley leaf tea had no observed effect on any of the urinary biochemical or physicochemical parameters in a statistically significant way.
| Discussion|| |
There are many potential effects of diet to increase or decrease the risk of nephrolithiasis. Kidney stones have been attributed to excessive dietary intake of protein, salt and oxalate  as well as diminished intake of fluids and calcium .,
No studies have previously evaluated the effect of parsley tea on urinary stone risk factors or inhibitors. Parsley (Petroselinum crispum) is originally a native plant of the Mediterranean region. Parsley, due to its constituents apiol and myristicin, is believed to have a diuretic effect, ,, and because diuretics increase the flow of urine, this might help the body to wash out bacteria as well as stones. Parsley contains calcium, iron, carotenes, ascorbic acid, and vitamin A.  The effect of ascorbic acid on urinary oxalate and urinary risk factors was studied. Because ascorbic acid is endogenously converted to oxalate and appears to increase the absorption of dietary oxalate, supplementation may increase the risk of kidney stones. 
We investigated the effect of parsley leaf tea ingestion on urinary composition and stone forming inhibitors. Unlike the findings in previous studies on the effects of cranberry juice, , black currant juice,  and orange  and lemon  juice consumption, there was no net effect on the urine composition, which is a risk of urinary tract stone formation or the inhibitors.
There are many factors that can affect our results, including compliance of volunteers, boiling temperature and its effect on the active components of the parsley tea, and the quantity of parsley leaf in the tea and its effect on drink concentration.
We conclude that parsley leaf tea has no significant change on urine composition or risk of urinary tract stone formation. This finding cannot be generalized because this study was conducted in healthy subjects, and further research is needed to evaluate the effects of parsley leaf tea on urinary parameters in healthy and stone-forming patients.
| References|| |
|1.||Ramello A, Vitale C, Marangella M. Epidemiology of nephrolithiasis. J Nephrol 2000; 13:45-50. |
|2.||Kohrmann KU, Rassweiler J, Alken P. The recurrence rate of stones following ESWL. World J Urol 1993;11:26-30. |
|3.||Sutherland JW. Recurrence following operative treatment of upper urinary tract stone. J Urol 1982;127:472-4. |
|4.||Tanagho EA, McAninch JW. Smith's General Urology. 16 th ed. Urinary stone disease. New York: Lange, McGraw-Hill; 2004, 256-87. |
|5.||Borghi L, Meschi T, Amato F, Briganti A, Novarini A, Giannini A. Urinary volume, water and recurrences in idiopathic calcium nephrolithiasis: A 5-year randomized prospective study. J Urol 1996;155:839-43. |
|6.||Meschi T, Schianchi T, Ridolo E, et al. Body weight, diet and water intake in preventing stone disease. Urol Int 2004;72:29-33. |
|7.||McHarg T, Rodgers A, Charlton K. Influence of cranberry juice on the urinary risk factors for calcium oxalate kidney stone formation. BJU Int 2003;92:765-8. |
|8.||Gettman MT, Ogan K, Brinkley LJ, Adams-Huet B, Pak CY, Pearle MS. Effect of cranberry juice consumption on urinary stone risk factors. J Urol 2005;174:590-4. |
|9.||Kessler T, Jansen B, Hesse A. Effect of blackcurrant-, cranberry- and plum juice consumption on risk factors associated with kidney stone formation. Eur J Clin Nutr 2002;56:1020-3. |
|10.||Wabner CL, Pak CY. Effect of orange juice consumption on urinary stone risk factors. J Urol 1993;149:1405-8. |
|11.||Seltzer MA, Low RK, McDonald M, Shami GS, Stoller ML. Dietary manipulation with lemonade to treat hypocitraturic calcium nephrolithiasis. J Urol 1996;156:907-9. |
|12.||Parivar F, Low RK, Stoller ML. The influence of diet on urinary stone disease. J Urol 1996;155:432-40. |
|13.||Curhan GC, Willett WC, Rimm EB, Stampfer MJ. A prospective study of dietary calcium and other nutrients and the risk of symptomatic kidney stones. N Engl J Med 1993;25:328:833-8. |
|14.||Curhan GC, Willett WC, Speizer FE, Spiegelman D, Stampfer MJ. Comparison of dietary calcium with supplemental calcium and other nutrients as factors affecting the risk for kidney stones in women. Ann Intern Med 1997;126: 497-504. |
|15.||Tyler V. Herbs of Choice. New York: Pharmaceutical Product Press; 1994,75-6. |
|16.||Newall C, Anderson L, Phillipson J. Herbal Medicine. A Guide for Health-Care Professionals. London: Pharmaceutical Press; 1996, 203-4. |
|17.||Kreydiyyeh SI, Usta J. Diuretic effect and mechanism of action of parsley. J Ethnopharmacol 2002;79:353-7. |
|18.||Review of Natural Products. St. Louis, MO: Facts and Comparisons; 1991. |
|19.||Massey LK, Liebman M, Kynast-Gales SA. Ascorbate Increases Human Oxaluria and Kidney Stone Risk. J Nutr 2005;135:1673-7. |
Fahad A Alyami
Department of Surgery, Division of Urology, King Khalid University Hospital, P.O. Box 7805, Riyadh 11472