scholarly journals Acute kidney injury associated with ingestion of star fruit: Acute oxalate nephropathy

2016 ◽  
Vol 26 (6) ◽  
pp. 446 ◽  
Author(s):  
AK Barman ◽  
R Goel ◽  
M Sharma ◽  
PJ Mahanta
2017 ◽  
Vol 7 (4) ◽  
pp. 290-292
Author(s):  
Hugo Abensur ◽  
Karina dos Santos Falani ◽  
Roberto Buessio ◽  
Fabiana Toledo Bueno ◽  
Dino Martini Filho ◽  
...  

2017 ◽  
Vol 19 (1) ◽  
pp. 63-65 ◽  
Author(s):  
Abdul Mumith Ruhan ◽  
Parash Ullah ◽  
Md Moyeen Uddin ◽  
MM Jahangir Alam ◽  
Md Shafiqul Bari ◽  
...  

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


2016 ◽  
Vol 48 (1-2) ◽  
pp. 37-39 ◽  
Author(s):  
Md Arshad Ul Azim ◽  
Abdus Salam

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


2014 ◽  
Vol 36 (2) ◽  
pp. 246-249 ◽  
Author(s):  
Karilla Lany Scaranello ◽  
Valeria Regina de Cristo Alvares ◽  
Daniely Maria Queiroz Carneiro ◽  
Flávio Henrique Soares Barros ◽  
Thais Marques Sanches Gentil ◽  
...  

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Sreeja Nair ◽  
Jacob George ◽  
Sajeev Kumar ◽  
Noble Gracious

Plant toxins are known to cause acute kidney injury in tropical countries. We report two cases of acute kidney injury with tubular oxalate deposition following ingestion ofAverrhoa bilimbifruit juice. Both patients had complete renal recovery though one required dialytic support.


2017 ◽  
Vol 6 (2) ◽  
pp. 30-33
Author(s):  
Nazneen Mahmood

Now a day Acute Kidney Injury and Chronic Kidney Disease are the two common problems worldwide with increased mortality and morbidity as well as health care cost. Nephrotoxicity and neurotoxicity by the Star fruit, sometimes fatal, is far more frequent than reported. Star fruit belongs to the Oxalidaceae family, species Averrhoea carambola, is a popular fruit among Orientals. The aim of the study is to create awareness among the population regarding star fruit intoxication, to reduce the development of Acute Kidney Injury in general population, to reduce the mortality and burden of morbidity from chronic renal failure, to reduce the mortality of the patients of End stage renal disease taking regular haemodialysis and to reduce the mortality and burden of morbidity of the people suffering from Diabetes mellitus and Hypertension. Star fruit juice produces acute renal injury not only through the obstructive effect of calcium oxalate crystals, but also inducing apoptosis of renal epithelial cells, which may be caused by the levels of oxalate in the fruit. There have been reports of hiccup, confusion and occasional fatal outcomes in uremic patients after ingestion of star fruit. An excitatory neurotoxin from star fruit has been implicated although the exact nature of this toxic substance has not been identified. High quantities of oxalate in empty stomach and dehydrated state may pose an additional risk for development of renal injury. To avoid acute oxalate nephropathy, pure sour carambola juice or mild diluted post pickled juice should not be consumed in large amounts, especially in an empty stomach and dehydrated state. It is recommended that uremic patients should totally abstain from star fruit due the rare but potentially fatal complications.Anwer Khan Modern Medical College Journal Vol. 6, No. 2: July 2015, P 30-33


2017 ◽  
Vol 10 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Tabassum Samad ◽  
Wasim M. Mohosin ul Haque ◽  
Muhammad A. Rahim ◽  
Sarwar Iqbal ◽  
Palash Mitra

Toxin is a common cause of community acquired acute kidney injury (AKI) which includes environmental toxins like plant toxins as well as various drugs and chemicals which are usually ingested for medicinal as well as recreational purposes.Averrhoa carambola(Star fruit/ Kamranga) andAvorrhoa bilimbiare two such commonly used traditional remedies. They belong to familyOxalidaecaeand contain high-levels of oxalic acid. AKI may occur after consuming concentrated juice due to deposition of oxalate crystals in the renal tubules.Here we present two patients who developed AKI after ingestion of freshly made juice from A. bilimbi and star fruit. Both patients were diabetic and the juice was ingested on empty stomach with the belief of improving glycemic status. Initial presentation was GI upset in both scenarios. Patient with A. bilimbi toxicity had diabetic nephropathy and required hemodialysis. Renal biopsy revealed deposition of polarizable oxalate crystals in the patient who consumed A. bilimbi and acute tubular necrosis in the patient with star fruit toxicity. All cases regained normal renal function within three months.We also present a patient who ingested raw fish gallbladder as a remedy for asthma. The patient presented with AKI within five days of ingestion and required hemodialysis. His highest serum creatinine was 10.4mg/dl and fell to 1.7 mg/dl after four weeks. Cyprinol and related compounds in fish gallbladder are thought to be the cause of acute tubular necrosis in such cases.The fourth patient developed AKI with rhabdomyolysis after consuming a locally made energy drink. He also required dialysis and serum creatinine gradually improved from 7.2mg/dl to 1.4mg/dl at discharge. The possibility of toxicity of caffeine, adulteration with other chemicals or ascorbic acid toxicity causing oxalate nephropathy could not be excluded.All four patients developed AKI caused after ingesting easily available products and are presented here for public awareness. We believe proper knowledge and education can reduce toxin induced AKI in our society.


2017 ◽  
Vol 7 (1) ◽  
pp. 33-35
Author(s):  
Sayed Fazlul Islam ◽  
KBM Hadizzaman ◽  
Syed Mahbub Morshed ◽  
Md Omar Faroque ◽  
AH Hamid Ahmed ◽  
...  

Acute kidney injury can occur due to various reasons. In this case report two cases of acute kidney injury (AKI) were reported after ingestion of 250 ml of starfruit juice presented. In both cases features of nephrotoxicity and neurotoxicity were found and there was mild to moderate rise in serum creatinine. Routine and microscopic examination of urine showed mild degree of proteinuria, no other active urinary sediment was found except calcium oxalate crystals. Renal biopsy was done in both cases which showed features of acute tubular necrosis. These two patients were treated symptomatically and discharged with normal serum creatinine. There is no case report of acute kidney injury due to star fruit ingestion in Bangladesh. Star fruit is very popular, cheap and easily available. But its nephrotoxic effect is not known to general population. These two case reports might be a first time message to the nation.J Shaheed Suhrawardy Med Coll, 2015; 7(1):33-35


2016 ◽  
Vol 7 (2) ◽  
pp. 151 ◽  
Author(s):  
Mehruba Alam Ananna ◽  
Rubayet Hasan ◽  
Tabassum Samad ◽  
Mohammad Abdur Rahim ◽  
Mohammad Erfanur Rahman ◽  
...  

<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>


2019 ◽  
Vol 8 (2) ◽  
pp. 47-51
Author(s):  
Mahmud Javed Hasan ◽  
Nitai Chandra Ray ◽  
Shaikh Shariful Islam ◽  
Shakil Azam Nahid ◽  
Tumpa Shom ◽  
...  

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


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