scholarly journals Star fruit intoxication leading to acute kidney injury

2016 ◽  
Vol 48 (1-2) ◽  
pp. 37-39 ◽  
Author(s):  
Md Arshad Ul Azim ◽  
Abdus Salam
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Disease ◽  
Normal Renal Function ◽  
Case Reports ◽  
Kidney Injury ◽  
Young Male ◽  
Star Fruit ◽  
Oxalate Nephropathy

There are few case reports regarding star fruit's nephrotoxicity and neurotoxicity in chronic kidney disease patients. Recently cases are found in people with normal renal function Star fruit nephrotoxicity is believed to be due to its high oxalate content which causes acute obstructive oxalate nephropathy. A neurotoxin (caramboxin) present in the fruit is responsible for neurotoxic features. Here we present a young male who developed acute kidney injury following star fruit ingestion in empty stomach. After admission, patient was treated conservatively and recovered completely.Bang Med J (Khulna) 2015; 48 : 37-39

Acute kidney injury associated with ingestion of star fruit: Acute oxalate nephropathy: a report of two cases

2019 ◽  
Vol 8 (2) ◽  
pp. 47-51
Author(s):  
Mahmud Javed Hasan ◽  
Nitai Chandra Ray ◽  
Shaikh Shariful Islam ◽  
Shakil Azam Nahid ◽  
Tumpa Shom ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Normal Renal Function ◽  
Herbal Remedy ◽  
Case Reports ◽  
Kidney Injury ◽  
Young Male ◽  
Empty Stomach ◽  
Star Fruit ◽  
History Of

There are few case reports regarding star fruit's nephrotoxicity and neurotoxicity in chronic kidney disease patients. Star fruit (Averrhoa carambola) is commonly consumed as a herbal remedy for various ailments in tropical countries. However, the dangers associated with consumption of star fruit are not commonly known. Although star fruit induced oxalate nephrotoxicity in those with existing renal impairment is well documented, reports on its effect on those with normal renal function are infrequent. We report two unique clinical presentation patterns of star fruit nephrotoxicity following consumption of the fruit. The first patient is a 52 year-old male diabetic patient who had normal renal function prior to developing acute kidney injury (AKI) after consuming large amount of star fruit juice at once for remedy of diabetes. The second patient, a 27 years old young male who developed acute kidney injury following star fruit ingestion in empty stomach. One case needed 4 sessions of hemodialysis another case recovered over 2 weeks without the need for haemodialysis. Consumption of star fruit, especially on an empty stomach or in a state of dehydration may precipitate acute kidney injury. A history of star fruit ingestion must be actively looked for in patients presenting with unexplained acute kidney injury. The use of star fruit as a therapy for diabetes should be discouraged. CBMJ 2019 July: Vol. 08 No. 02 P: 47-51

scholarly journals Acute Kidney Injury Following Star Fruit (Averrhoa carambola) Ingestion in a Previously Healthy Young Man

2017 ◽  
Vol 19 (1) ◽  
pp. 63-65 ◽  
Author(s):  
Abdul Mumith Ruhan ◽  
Parash Ullah ◽  
Md Moyeen Uddin ◽  
MM Jahangir Alam ◽  
Md Shafiqul Bari ◽  
...  
Keyword(s):  
Acute Kidney Injury ◽  
Renal Function ◽  
Renal Impairment ◽  
Normal Renal Function ◽  
Kidney Injury ◽  
Averrhoa Carambola ◽  
Star Fruit ◽  
Patient’S History ◽  
Oxalate Nephropathy

Star fruit (Averrhoa carambola) is a commonly available and popular fruit in many tropical and subtropical countries. Although star fruit induced oxalate nephropathy in patients with pre-existing renal impairment is well documented, reports on its effect on those with normal renal function are infrequent. Hereby we report a case where a young man with previously normal renal function presented with AKI that was attributable to consumption of star fruit. This write up illustrates the importance of obtaining the patient’s history with respect to ingestion of star fruit in case of sudden and unexplained development of renal impairment.J MEDICINE Jan 2018; 19 (1) : 63-65

scholarly journals Acute kidney injury pathology and pathophysiology: a retrospective review

2020 ◽  
Author(s):  
Joseph P Gaut ◽  
Helen Liapis
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Disease ◽  
Renal Biopsy ◽  
Retrospective Review ◽  
Patient Management ◽  
Kidney Injury ◽  
High Morbidity ◽  
Underlying Pathology

Abstract Acute kidney injury (AKI) is the clinical term used for decline or loss of renal function. It is associated with chronic kidney disease (CKD) and high morbidity and mortality. However, not all causes of AKI lead to severe consequences and some are reversible. The underlying pathology can be a guide for treatment and assessment of prognosis. The Kidney Disease: Improving Global Outcomes guidelines recommend that the cause of AKI should be identified if possible. Renal biopsy can distinguish specific AKI entities and assist in patient management. This review aims to show the pathology of AKI, including glomerular and tubular diseases.

scholarly journals Acute kidney injury due to star fruit ingestion: A case report

2016 ◽  
Vol 7 (2) ◽  
pp. 151 ◽  
Author(s):  
Mehruba Alam Ananna ◽  
Rubayet Hasan ◽  
Tabassum Samad ◽  
Mohammad Abdur Rahim ◽  
Mohammad Erfanur Rahman ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Case Report ◽  
Fruit Juice ◽  
Kidney Injury ◽  
Renal Function Impairment ◽  
Star Fruit ◽  
Function Impairment ◽  
The World

<p>Star fruit (Avarrhoa carambola) is a fruit from oxalidace family. lt is found in many countries of the world including Bangladesh. But its ingestion or drinking star fruit juice may lead to intoxication especially in patients with chronic kidney disease and manifestations might be neurological or nephrological. lt may also cause acute kidney injury in patients with previously normal renal function. Here we are presenting a case who presented with acute kidney injury after star fruit ingestion with previously unknown renal function impairment. The etiology was confirmed by histopathological exami­nation after doing renal biopsy. This renal function impairment is mainly due to oxalate crystal induce nephropathy which is richly abundant in star fruit. His renal function was improved ·with conservative management. Physicians should be alert to consider the ingestion of star fruit as a cause of acute kidney injury in a patient even in the absence of previous renal function impairment.</p>

scholarly journals Impact on Outcomes across KDIGO-2012 AKI Criteria According to Baseline Renal Function

2019 ◽  
Vol 8 (9) ◽  
pp. 1323 ◽  
Author(s):  
Isabel Acosta-Ochoa ◽  
Juan Bustamante-Munguira ◽  
Alicia Mendiluce-Herrero ◽  
Jesús Bustamante-Bustamante ◽  
Armando Coca-Rojo
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Disease ◽  
Hospital Mortality ◽  
Kidney Injury ◽  
Clinical Syndrome ◽  
Increment Rate ◽  
Associated Risk Factors ◽  
Baseline Renal Function

Acute kidney injury (AKI) and Chronic Kidney Disease (CKD) are global health problems. The pathophysiology of acute-on-chronic kidney disease (AoCKD) is not well understood. We aimed to study clinical outcomes in patients with previous normal (pure acute kidney injury; P-AKI) or impaired kidney function (AoCKD) across the 2012 Kidney Disease Improving Global Outcomes (KDIGO) AKI classification. We performed a retrospective study of patients with AKI, divided into P-AKI and AoCKD groups, evaluating clinical and epidemiological features, distribution across KDIGO-2012 criteria, in-hospital mortality and need for dialysis. One thousand, two hundred and sixty-nine subjects were included. AoCKD individuals were older and had higher comorbidity. P-AKI individuals fulfilled more often the serum creatinine (SCr) ≥ 3.0× criterion in AKI-Stage3, AoCKD subjects reached SCr ≥ 4.0 mg/dL criterion more frequently. AKI severity was associated with in-hospital mortality independently of baseline renal function. AoCKD subjects presented higher mortality when fulfilling AKI-Stage1 criteria or SCr ≥ 3.0× criterion within AKI-Stage3. The relationship between mortality and associated risk factors, such as the net increase of SCr or AoCKD status, fluctuated depending on AKI stage and stage criteria sub-strata. AoCKD patients that fulfil SCr increment rate criteria may be exposed to more severe insults, possibly explaining the higher mortality. AoCKD may constitute a unique clinical syndrome. Adequate staging criteria may help prompt diagnosis and administration of appropriate therapy.

Increased progression to kidney fibrosis after erythropoietin is used as a treatment for acute kidney injury

2014 ◽  
Vol 306 (6) ◽  
pp. F681-F692 ◽  
Author(s):  
Glenda C. Gobe ◽  
Nigel C. Bennett ◽  
Malcolm West ◽  
Paul Colditz ◽  
Lindsay Brown ◽  
...  
Keyword(s):  
Oxidative Stress ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Renal Ischemia ◽  
Acute Injury

Treatment of renal ischemia-reperfusion (IR) injury with recombinant human erythropoietin (rhEPO) reduces acute kidney injury and improves function. We aimed to investigate whether progression to chronic kidney disease associated with acute injury was also reduced by rhEPO treatment, using in vivo and in vitro models. Rats were subjected to bilateral 40-min renal ischemia, and kidneys were studied at 4, 7, and 28 days postreperfusion for renal function, tubular injury and repair, inflammation, and fibrosis. Acute injury was modulated using rhEPO (1,000 or 5,000 IU/kg, intraperitoneally) at the time of reperfusion. Renal tubular epithelial cells or fibroblasts in culture were subjected to hypoxia or oxidative stress, with or without rhEPO (200 IU/ml), and fibrogenesis was studied. The results of the in vivo model confirmed functional and structural improvement with rhEPO at 4 days post-IR ( P < 0.05). At 7 days post-IR, fibrosis and myofibroblast stimulation were increased with IR with and without rhEPO ( P < 0.01). However, at 28 days post-IR, renal fibrosis and myofibroblast numbers were significantly greater with IR plus rhEPO ( P < 0.01) compared with IR only. Mechanistically, rhEPO stimulated profibrotic transforming growth factor-β, oxidative stress (marker 8-hydroxy-deoxyguanosine), and phosphorylation of the signal transduction protein extracellular signal-regulated kinase. In vitro, rhEPO protected tubular epithelium from apoptosis but stimulated epithelial-to-mesenchymal transition and also protected and activated fibroblasts, particularly with oxidative stress. In summary, although rhEPO was protective of renal function and structure in acute kidney injury, the supraphysiological dose needed for renoprotection contributed to fibrogenesis and stimulated chronic kidney disease in the long term.

Evaluation of renal function in primary care

2018 ◽  
Vol 8 (2) ◽  
pp. 202-205
Author(s):  
B. Musiałowska ◽  
M. Rudzińska ◽  
E. Koc-Żórawska ◽  
M. Żórawski
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Kidney Disease ◽  
Chronic Diseases ◽  
Kidney Injury ◽  
Treatment Monitoring ◽  
Primary Care Patients ◽  
Drug Doses

Evaluation of renal function is one of the primary tools used in treatment and monitoring kidney injury such as acute kidney injury (AKI) or chronic kidney disease (CKD) in Primary Care patients. Accompanying chronic diseases also have an impact on the assessment of renal function, treatment monitoring and adjustment of drug doses.

scholarly journals Star fruit toxicity: a cause of both acute kidney injury and chronic kidney disease: a report of two cases

2015 ◽  
Vol 8 (1) ◽  
Author(s):  
R. A. Abeysekera ◽  
S. Wijetunge ◽  
N. Nanayakkara ◽  
A. W. M. Wazil ◽  
N. V. I. Ratnatunga ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Kidney Disease ◽  
Kidney Injury ◽  
Star Fruit

scholarly journals Using circulating O-sulfotyrosine in the differential diagnosis of acute kidney injury and chronic kidney disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shuai Chen ◽  
Yong-Hua Liu ◽  
Dao-Peng Dai ◽  
Zheng-Bin Zhu ◽  
Yang Dai ◽  
...  
Keyword(s):  
Chronic Kidney Disease ◽  
Acute Kidney Injury ◽  
Renal Function ◽  
Differential Diagnosis ◽  
Kidney Disease ◽  
Linear Regression Analysis ◽  
Kidney Injury ◽  
Serum Levels ◽  
Multivariate Linear Regression Analysis ◽  
Post Translational Modification

Abstract Background Sulfation of tyrosine, yielding O-sulfotyrosine, is a common but fixed post-translational modification in eukaryotes. Patients with increased circulating O-sulfotyrosine levels experience a faster decline in renal function with progression to end-stage renal disease (ESRD). In the present study, we measured serum O-sulfotyrosine levels in individuals with chronic kidney disease (CKD) and acute kidney injury (AKI) to explore its ability to differentiate AKI from CKD. Methods A total of 135 patients (20 with AKI and 115 with CKD) were recruited prospectively for liquid chromatography-mass spectrometry assessment of circulating O-sulfotyrosine. We also studied C57BL/6 mice with CKD after 5/6 nephrectomy (Nx). Blood samples were drawn from the tail vein on Day 1, 3, 5, 7, 14, 30, 60, and 90 after CKD. Serum separation and characterization of creatinine, blood urea nitrogen (BUN), and O-sulfotyrosine was performed. Thus, the time-concentration curves of the O-sulfotyrosine level demonstrate the variation of kidney dysfunction. Results The serum levels of O-sulfotyrosine were markedly increased in patients with CKD compared with AKI. Median O-sulfotyrosine levels in CKD patients versus AKI, respectively, were as follows:243.61 ng/mL(interquartile range [IQR] = 171.90–553.86) versus 126.55 ng/mL (IQR = 48.19–185.03, P = 0.004). In patients with CKD, O-sulfotyrosine levels were positively correlated with creatinine, BUN, and Cystatin C (r = 0.63, P < 0.001; r = 0.49, P < 0.001; r = 0.61, P < 0.001, respectively) by the multivariate linear regression analysis (β = 0.71, P < 0.001; β = 0.40, P = 0.002; β = 0.73, P < 0.001, respectively). However, this association was not statistically significant in patients with AKI (r = − 0.17, P = 0.472; r = 0.11, P = 0.655; r = 0.09, P = 0.716, respectively). The receiver operating characteristic (ROC) analysis illustrated that the area under the curve was 0.80 (95% confidence interval [CI] 0.71–0.89; P < 0.001) and the optimal cut-off value of serum O-sulfotyrosine suggesting AKI was < 147.40 ng/mL with a sensitivity and specificity of 80.90 and 70.00% respectively. In animal experiments, serum levels of O-sulfotyrosine in mice were elevated on Day 7 after 5/6 nephrectomy (14.89 ± 1.05 vs. 8.88 ± 2.62 ng/mL, P < 0.001) until Day 90 (32.65 ± 5.59 vs. 8.88 ± 2.62 ng/mL, P < 0.001). Conclusion Serum O-sulfotyrosine levels were observed correlated with degrading renal function and in CKD patients substantially higher than those in AKI patients. Thus serum O-sulfotyrosine facilitated the differential diagnosis of AKI from CKD.

Sign in / Sign up

Export Citation Format

Share Document