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2015 ; 8
(ä): 796
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Star fruit toxicity: a cause of both acute kidney injury and chronic kidney
disease: a report of two cases
#MMPMID26680759
Abeysekera RA
; Wijetunge S
; Nanayakkara N
; Wazil AW
; Ratnatunga NV
; Jayalath T
; Medagama A
BMC Res Notes
2015[Dec]; 8
(ä): 796
PMID26680759
show ga
BACKGROUND: 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 as a remedy for diabetes
mellitus-the first, in a patient with normal renal function and the second case
which we believe is the first reported case of chronic kidney disease (CKD) due
to prolonged and excessive consumption of star fruits. CASE PRESENTATION: The
first patient is a 56-year-old female diabetic patient who had normal renal
function prior to developing acute kidney injury (AKI) after consuming large
amount of star fruit juice at once. The second patient, a 60-year-old male, also
diabetic presented with acute on chronic renal failure following ingestion of a
significant number of star fruits in a short duration with a background history
of regular star fruit consumption over the past 2-3 years. Both had
histologically confirmed oxalate induced renal injury. The former had
histological features of acute tubulo-interstitial disease whilst the latter had
acute-on-chronic interstitial disease; neither had histological evidence of
diabetic nephropathy. Both recovered over 2 weeks without the need for
haemodialysis. CONCLUSION: These cases illustrate the importance of obtaining the
patient's detailed history with respect to ingestion of herbs, traditional
medication and health foods such as star fruits especially in AKI or CKD of
unknown cause.
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