Urolithiasis, a clinicalcondition involving the formation of calculi in the urinary tract (Smith,2016), has been reported with an increased prevalence and of clinicalsignificance in the field of medicine (Chen, 2012). Considering the lifestyleand dietary choices of the majority, such is noted to contribute in the list ofthe most common health conditions (Yasui et al., 2016). Smith (2016) estimated10% of the world’s population has renal calculi. However, most urolithiaticconditions remain asymptomatic, because minute stones do not have any effectyet, making people unaware of the serious problem they have and would only feelburden as the size increases. Preminger and Glenn (2017) stated that 1 per 1000of the population is hospitalized due to renal calculi since larger stones cause pain in the lower abdomen and renalcolic, which is characterized as an excruciating pain in the area between thehips and ribs.
Renal stone formation may also lead to pyelonephritis and acuterenal failure (Yasui et al., 2016). Hence, the need for medical interventionswhich include lithotripsy, stone-bypass procedures, endoscopic techniques andsurgical removal. (Preminger and Glenn, 2017).Renal calculi agglomeratein the urinary tract as a result of an increase in the accumulation ofcrystal-forming substances which includes calcium, oxalate, uric acid andphosphates. (National Kidney Foundation NKF, 2017) Given the fact, theformation of kidney stones is proven to originate from urine crystals whichaccumulate either in the kidneys or the urinary tract. Most common of which isthe calcium-forming stone, calcium oxalate monohydrate and calcium oxalatedihydrate (Colella, 2005).There arethree general pathways for the formation of renal calculi.
Evans (2010)discussed about the Randall’s plaque which is the formation of stone in thesurface of renal papilla. Eventually, as seen in hyperoxaluria, stones areattached in the opening ducts of Bellini. Finally, stones are formed in freesolution in the renal collection system, as seen in cystinuria. Futherexplanation about the origin of stone formation is narrowed into thedevelopment of crystals, more particularly calcium oxalate. Ratkalkar andKleinman (2011) enumerated the pathogenesis into nucleation, crystal growth,crystal aggregation and crystal retention. Stone-formers’ urine and theirtubular fluid is supersaturated thus a favorable condition for nucleation andgrowth of crystals.Currently, the usage of synthetic medicines results inhigher incidence of adverse medical reactions in compare with the effects ofherbal medicines (Chen, 2012), motivating the community to return to naturalremedies such as herbals and plants for a safer way of treatment.
Recent studies prove theadvantages of phytochemicals in the field of herbal therapy. Such are definedas non-nutritional constituents of plants which includes flavonoids,carotenoids, isoflavonoids and phenolic acids. (NutritionJournal. 2004) Hence, the usage of phytochemicals have been prevalent for theconstruction of alternative medicine which will provide lesser adverse effectson individuals. Majority of compounds found in plants and vegetables areflavonoids. More so, numerous are proved to be extracted from apples. Malus domestica, Fuji apple, is described to be a significantsource of flavonoids and twenty-two percent of phenolic compounds absorbed fromfruits are found in apples. This scenario made such fruit to be described asthe largest source of phenolic.
(NutritionJournal. 2004)Malus domestica are known to be the mostcultivated apples. Such are widely consumed by insects, birds and man. More so,the tree of such producesabundant white-pink flowers during early spring. Malus domestica came from the family, Rosaceae, and inhabits in terrestrial land.The fruit contains a variety of phytochemicals such asquercetin, catechin, phloridzin and cholorogenic acid. The composition of thefruit comprises high phenolic compounds, apple peels to have a higher contentin compare with the pulp.
The qualitative differences of the apple peel andpulp were caused by the presence of flavanol glycosides and high levels ofchlorogenic acid and catechins. (A. Escarpa , M.C. Gonzalez 1998)Catechin is defined as atype of flavonoid that are considered to be potent antioxidants that aids inthe prevention of damaging chemicals known as free radicals. Most are found infruits and vegetables including green tea, cocoa and beans. (J.
Marie, 2015) Experimental analysis also proved thepresence of such in apples with higher concentrations. (A. Escarpa, M.C. Gonzalez 1998) In-vivo experimentation, on the other hand, provided a basiswherein such phenolic compound mitigates nephrotoxicity and pathological renaldisorder induced by melamine and cyanuric acid compounds. Furthermore,conclusions have described catechins to possess protective abilities in lithicnephropathy, urolithiasis. Quercetin, another activecomponent found in apples, known as a flavanol is a polyphenolic compoundpresent ubiquitously in foods of plant origin.
Same with cathechin, the saidcomponent also contains an antioxidant property which are found as well in thepeels of apple with high concentrations. (Lommen, A. et al., 2000) Experimental analysis showed thatflavanol quercetin is one of the compound found in the extract of Perseaamericana Mill, avocado, that contributes as a phytotherapeutic agent for theprevention of urolithiasis diseases. (HAYATI Journal of Biosciences,2012).