The Effect of Using Black Tea as an Alternative Diuretic on Multislice Computed Tomography (MSCT) Urography Examination


  • dina widyasari Politeknik Kesehatan Kemenkes Semarang
  • Lina Choridah Universitas Gadjah Mada
  • Jeffry Ardiyanto Politeknik Kesehatan Kementerian Kesehatan Semarang

Abstract views 30 times


Keywords: black tea; Curved Multiplanar Reconstruction; diuretic; MSCT urography; kidney stones


The MSCT urography examination requires patient preparation, such as fasting and drinking water.In addition,some hospitals use water,furosemide to accelerate the increase in urine volume.However,Furosemide is a chemical diuretic that is feared to increase the workload of the kidneys. So a natural alternative is needed, namely black tea.This study aims to determine the effect of black tea as an alternative diuretic on the urography MSCT examination. This is quasi-experimental research conducted at RSUD by Dr. Soehadi Prijonegoro Sragen,Central Java. Respondents in this study consisted of 18 outpatients with an MSCT urography examination. These respondents were divided into three groups, namely the group of mineral water, furosemide,and black tea, and three radiology doctors. The scanning process uses MSCT 128 Slice and then tracks MSCT urography with the Curved Multiplanar Reconstruction (MPR) application.Data obtained from observations,questionnaires,and interviews with radiologists was then processed and analyzed using quantitative methods.Normal distributed data was analyzed using the ANOVA test. The results showed a significant difference from the assessment of kidney HU,liver HU, and ureteral dilatation in the mineral water, furosemide, and black tea test groups with sig values.<0.05.Black tea increases Hounsfield Unit (HU) values in the kidneys,lungs,liver,and ureteral dilation, as a tracking picture shown in the Curved Multiplanar Reconstruction(MPR) application. This confirms that black tea can be used as a natural diuretic alternative for some reasons:effective, fast, easy, and inexpensive.It makes it easier to track kidney stones.The operation of curved multiplanar reconstruction(MPR) applications during reconstruction can display more optimal image results to support more accurate diagnostic information.


Abeywickrama, K. R. W., Ratnasooriya, W. D., & Amarakoon, A. M. T. (2010). Oral diuretic activity of hot water infusion of Sri Lankan black tea (Camellia sinensis L.) in rats. Pharmacognosy Magazine, 6(24), 271–277.

Alelign, T., & Petros, B. (2018). Kidney Stone Disease: An Update on Current Concepts. Advances in Urology, 2018, 3068365.

Alexander, R. T., Hemmelgarn, B. R., Wiebe, N., Bello, A., Samuel, S., Klarenbach, S. W., Curhan, G. C., & Tonelli, M. (2014). Kidney Stones and Cardiovascular Events: A Cohort Study. Clinical Journal of the American Society of Nephrology, 9(3), 506.

Alexander, S. P. H. (2006). Flavonoids as antagonists at A1 adenosine receptors. Phytotherapy Research: PTR, 20(11), 1009–1012.

Corbo, J., & Wang, J. (2019). Kidney and Ureteral Stones. Emergency Medicine Clinics of North America, 37(4), 637–648.

Dhondup, T., Kittanamongkolchai, W., Vaughan, L. E., Mehta, R. A., Chhina, J. K., Enders, F. T., Hickson, L. J., Lieske, J. C., & Rule, A. D. (2018). Risk of ESRD and Mortality in Kidney and Bladder Stone Formers. American Journal of Kidney Diseases, 72(6), 790–797.

Fa’ik, M. (2018). Utilization of furosemide to increase urine production as a negative contrast media in CT urography. International Journal of Allied Medical Sciences and Clinical Research, 6(3), Article 3.

Ferraro, P. M., Taylor, E. N., Eisner, B. H., Gambaro, G., Rimm, E. B., Mukamal, K. J., & Curhan, G. C. (2013). History of Kidney Stones and the Risk of Coronary Heart Disease. JAMA, 310(4), 408–415.

Gross, D. W., Misaghi, E., Steve, T. A., Wilman, A. H., & Beaulieu, C. (2020). Curved multiplanar reformatting provides improved visualization of hippocampal anatomy. Hippocampus, 30(2), 156–161.

Hamimi, A., & El Azab, M. (2016). MSCT renal stone protocol; dose penalty and influence on management decision of patients: Is it really worth the radiation dose? The Egyptian Journal of Radiology and Nuclear Medicine, 47(1), 319–324.

Huyut, Z., Beydemir, Ş., & Gülçin, İ. (2016). Inhibitory effects of some phenolic compounds on the activities of carbonic anhydrase: From in vivo to ex vivo. Journal of Enzyme Inhibition and Medicinal Chemistry, 31(6), 1234–1240.

Hyams, E. S., & Matlaga, B. R. (2014). Economic impact of urinary stones. Translational Andrology and Urology, 3(3), 278–283.

Jones, P., Karim Sulaiman, S., Gamage, K. N., Tokas, T., Jamnadass, E., & Somani, B. K. (2021). Do Lifestyle Factors Including Smoking, Alcohol, and Exercise Impact Your Risk of Developing Kidney Stone Disease? Outcomes of a Systematic Review. Journal of Endourology, 35(1), 1–7.

Khan, T. M., Patel, R., & Siddiqui, A. H. (2023). Furosemide. In StatPearls. StatPearls Publishing.

Kim, S. Y., Bang, W. J., Min, C., & Choi, H. G. (2020). Association of nephrolithiasis with the risk of cardiovascular diseases: A longitudinal follow-up study using a national health screening cohort. BMJ Open, 10(11), e040034.

Kittanamongkolchai, W., Mara, K. C., Mehta, R. A., Vaughan, L. E., Denic, A., Knoedler, J. J., Enders, F. T., Lieske, J. C., & , A. D. (2017). Risk of Hypertension among First-Time Symptomatic Kidney Stone Formers. Clinical Journal of the American Society of Nephrology : CJASN, 12(3), 476–482.

Klepacka, J., Tońska, E., Rafałowski, R., Czarnowska-Kujawska, M., & Opara, B. (2021). Tea as a Source of Biologically Active Compounds in the Human Diet. Molecules, 26(5), 1487.

Konieczynski, P., Viapiana, A., & Wesolowski, M. (2017). Comparison of Infusions from Black and Green Teas (Camellia sinensis L. Kuntze) and Erva-mate (Ilex paraguariensis A. St.-Hil.) Based on the Content of Essential Elements, Secondary Metabolites, and Antioxidant Activity. Food Analytical Methods, 10(9), 3063–3070.

Lampignano, J. P., & Kendrick, L. E. (2017). Bontrager’s Textbook of Radiographic Positioning and Related Anatomy (9th edition). Mosby.

Lee, C. H., Gu, H. Z., Vellayappan, B. A., & Tan, C. H. (2016). Water as neutral oral contrast agent in abdominopelvic CT: Comparing effectiveness with Gastrografin in the same patient. The Medical Journal of Malaysia, 71(6), 322–327.

Lipkin, M., & Ackerman, A. (2016). Imaging for urolithiasis: Standards, trends, and radiation exposure. Current Opinion in Urology, 26(1), 56–62.

Liu, Y., Li, S., Zeng, Z., Wang, J., Xie, L., Li, T., He, Y., Qin, X., & Zhao, J. (2014). Kidney Stones and Cardiovascular Risk: A Meta-analysis of Cohort Studies. American Journal of Kidney Diseases, 64(3), 402–410.

Liu, Y.-T., Yang, P.-Y., Yang, Y.-W., Sun, H.-Y., & Lin, I.-C. (2017). The association of nephrolithiasis with metabolic syndrome and its components: A cross-sectional analysis. Therapeutics and Clinical Risk Management, 13, 41–48.

Makarawo, T. P., Negussie, E., Malde, S., Tilak, J., Gayagoy, J., Watson, J., Francis, F., Lincoln, D., & Jacobs, M. J. (2013). Water as a contrast medium: A re-evaluation using the multidetector-row computed tomography. The American Surgeon, 79(7), 728–733.

Meharie, B. G., & Tunta, T. A. (2020). Evaluation of Diuretic Activity and Phytochemical Contents of Aqueous Extract of the Shoot Apex of Podocarpus falcactus. Journal of Experimental Pharmacology, 12, 629–641.

Modersitzki, F., Pizzi, L., Grasso, M., & Goldfarb, D. S. (2014). Health-related quality of life (HRQoL) in cystine compared with non-cystine stone formers. Urolithiasis, 42(1), 53–60.

Nojaba, L., & Guzman, N. (2023). Nephrolithiasis. In StatPearls. StatPearls Publishing.

Peng, J.-P., & Zheng, H. (2017). Kidney stones may increase the risk of coronary heart disease and stroke. Medicine, 96(34), e7898.

Rukin, N. J., Siddiqui, Z. A., Chedgy, E. C. P., & Somani, B. K. (2017). Trends in Upper Tract Stone Disease in England: Evidence from the Hospital Episodes Statistics Database. Urologia Internationalis, 98(4), 391–396.

Rule, A. D., Bergstralh, E. J., Melton, L. J., Li, X., Weaver, A. L., & Lieske, J. C. (2009). Kidney Stones and the Risk for Chronic Kidney Disease. Clinical Journal of the American Society of Nephrology : CJASN, 4(4), 804–811.

Rule, A. D., Lieske, J. C., Li, X., Melton, L. J., Krambeck, A. E., & Bergstralh, E. J. (2014). The ROKS nomogram for predicting a second symptomatic stone episode. Journal of the American Society of Nephrology: JASN, 25(12), 2878–2886.

Shang, W., Li, Y., Ren, Y., Yang, Y., Li, H., & Dong, J. (2017). Nephrolithiasis and risk of hypertension: A meta-analysis of observational studies. BMC Nephrology, 18, 344.

Sigurjonsdottir, V. K., Runolfsdottir, H. L., Indridason, O. S., Palsson, R., & Edvardsson, V. O. (2015). Impact of nephrolithiasis on kidney function. BMC Nephrology, 16(1), 149.

Sorokin, I., Mamoulakis, C., Miyazawa, K., Rodgers, A., Talati, J., & Lotan, Y. (2017). Epidemiology of stone disease across the world. World Journal of Urology, 35(9), 1301–1320.

Sulaksono, N., Suryono, S., & Ardiyanto, J. (2016). Optimalisasi Citra Msct Traktus Urinarius Menggunakan Tracking Dengan Variasi Slice Thickness Dan Window Setting. Jurnal Riset Kesehatan, 5(1), 30–34.

Thakore, P., & Liang, T. H. (2023). Urolithiasis. In StatPearls. StatPearls Publishing.

Vargas, F., Romecín, P., García-Guillén, A. I., Wangesteen, R., Vargas-Tendero, P., Paredes, M. D., Atucha, N. M., & García-Estañ, J. (2018). Flavonoids in Kidney Health and Disease. Frontiers in Physiology, 9, 394.

Wang, K., Ge, J., Han, W., Wang, D., Zhao, Y., Shen, Y., Chen, J., Chen, D., Wu, J., Shen, N., Zhu, S., Xue, B., & Xu, X. (2022). Risk factors for kidney stone disease recurrence: A comprehensive meta-analysis. BMC Urology, 22(1), 62.

Welch, W. J. (2015). Adenosine, type 1 receptors: Role in proximal tubule Na+ reabsorption. Acta Physiologica (Oxford, England), 213(1), 242–248.

Whitehurst, L., Jones, P., & Somani, B. K. (2019). Mortality from kidney stone disease (KSD) as reported in the literature over the last two decades: A systematic review. World Journal of Urology, 37(5), 759–776.

Yudha, S., Hadisaputro, S. H., Ardiyanto, J., Mulyantoro, D. K., & Masrochah, S. (2020). BENEFITS OF STEEPING BLACK TEA AS A NEGATIVE CONTRAST MEDIUM ON CT UROGRAPHY EXAMINATION. Journal of Applied Health Management and Technology, 2(2), Article 2.






Original Research Paper