In Vivo Antiurolithiatic Activity of Leaves of Acalypha indica Linn. A Comprehensive Scientific Review

Urolithiasis (kidney stone disease) is a globally prevalent urological disorder affecting approximately 1–20% of the population worldwide, with a significant recurrence rate and considerable morbidity. Calcium oxalate stones constitute the most predominant type (>80% of cases). Despite advances in surgical interventions such as lithotripsy and percutaneous nephrolithotomy, pharmacological prevention remains a clinical challenge. Medicinal plants have historically served as a primary therapeutic resource in traditional medicine systems, and Acalypha indica Linn. (Family: Euphorbiaceae), known by vernacular names such as 'Kuppameni' (Tamil), 'Kuppi' (Hindi), and 'Indian Acalypha', is one of the most documented antiurolithiatic herbs in Ayurvedic and Siddha systems. This review comprehensively consolidates current evidence on the in vivo antiurolithiatic activity of A. indica leaf extracts, encompassing phytochemical constituents, experimental models (particularly the ethylene glycol-induced rat model), biochemical parameters including membrane-bound ATPases (Ca²⁺, Mg²⁺, Na⁺K⁺), marker enzymes (AST, ALT, ACP, ALP), oxidative stress markers, and histopathological observations. Mechanistic hypotheses involving antioxidant, diuretic, and crystal nucleation inhibition pathways are critically examined. The safety profile, acute toxicity data, and future research perspectives are also addressed. The accumulating evidence supports A. indica as a promising herbal candidate for antiurolithiatic drug development, though rigorous clinical validation remains essential.