Acute Oxalate Nephropathy After Ingestion of Star Fruit

Chen, Chien-Liang; Fang, Hua-Chang; Chou, Kang‐Ju; Wang, Jyh-Seng; Chung, Hsiao-Min

doi:10.1053/ajkd.2001.21333

Cited by 122 publications

(104 citation statements)

References 8 publications

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“…Oxalate nephropathy is a rare cause of acute and chronic renal failure (1)(2)(3)(4). Oxalate accumulation in renal allografts may arise de novo, or as "recurrence" of native kidney disease if underlying hyperoxalosis remains uncorrected.…”

Section: Introductionmentioning

confidence: 99%

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Enteric Oxalate Nephropathy in the Renal Allograft: An Underrecognized Complication of Bariatric Surgery

Troxell

Houghton

Hawkey³

et al. 2013

American Journal of Transplantation

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Enteric hyperoxalosis is a recognized complication of bariatric surgery, with consequent oxalate nephropathy leading to chronic kidney disease and occasionally end-stage renal failure. In patients with prior gastrointestinal bypass surgery, renal allografts are also at risk of oxalate nephropathy. Further, transplant recipients may be exposed to additional causes of hyperoxalosis. We report two cases of renal allograft oxalate nephropathy in patients with remote histories of bariatric surgery. Conservative management led to improvement of graft function in one patient, while the other patient returned to dialysis. Interpretation of serologic, urine and biopsy studies is complicated by oxalate accumulation in chronic renal failure, and heightened excretion in the early posttransplant period. A high index of suspicion and careful clinicopathologic correlation on the part of transplant nephrologists and renal pathologists are required to recognize and treat allograft oxalate nephropathy. As the incidence of obesity and pretransplant bariatric surgery increases in the transplant population, allograft oxalate nephropathy is likely to be an increasing cause of allograft dysfunction.

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Section: Introductionmentioning

confidence: 99%

“…Secondary hyperoxaluria can arise from a variety of different processes (Table 1), including iatrogenic causes. Gastrointestinal surgery is a known cause of hyperoxaluria, most notably in situations of fat malabsorption and diarrhea (1)(2)(3)(4).…”

Section: Introductionmentioning

confidence: 99%

Enteric Oxalate Nephropathy in the Renal Allograft: An Underrecognized Complication of Bariatric Surgery

Troxell

Houghton

Hawkey³

et al. 2013

American Journal of Transplantation

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“…Other rare causes include chronic pancreatitis (7), ethylene glycol (8), vitamin C (9), ingestion of foods with high levels of oxalate (10)(11)(12), and complication of some medications (3,13,14).…”

Section: Introductionmentioning

confidence: 99%

Primary Hyperoxaluria: A Case Report and Review of the Literature

2017

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Oxalate nephropathy is a rare cause of renal failure. Primary Hyperoxaluria (PH) is due to glyoxylate metabolism disorders with specific hepatic enzyme deficiencies. Secondary hyperoxaluria is caused by increased intestinal absorption, excessive dietary intake or excessive intake of oxalate precursors. This study reports on a 4-month-old male with high serum creatinine level, low serum sodium and calcium, high uric acid, and low urine specific gravity. Sonography showed calcification of medullary papilla (nephrocalcinosis). In kidney biopsy, many polarizing intra-tubular and interstitial calcium oxalate crystals, mild patchy lymphocytic infiltration, and interstitial fibrosis were noted. Despite supportive therapies and correction of fluid and electrolyte abnormalities, the patient gradually became oliguric progressing to anuria, and was placed on peritoneal dialysis.

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“…Star fruit is one of the plant sources that contain highest concentration of oxalic acid; 100 g of fresh fruit contains 50,000-95,800 ppm of oxalic acid 2 . Sour carambola juice is a popular beverage in Taiwan.…”

Section: Introductionmentioning

confidence: 99%

“…Sour carambola juice is a popular beverage in Taiwan. Commercial carambola juice usually is prepared by pickling and dilution processes that reduce oxalate content markedly 2 .…”

Section: Introductionmentioning

confidence: 99%

Star Fruit Intoxication

Mahmood¹

2017

Anwer Khan Mod Med Coll J

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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

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Acute Oxalate Nephropathy After Ingestion of Star Fruit

Cited by 122 publications

References 8 publications

Enteric Oxalate Nephropathy in the Renal Allograft: An Underrecognized Complication of Bariatric Surgery

Enteric Oxalate Nephropathy in the Renal Allograft: An Underrecognized Complication of Bariatric Surgery

Primary Hyperoxaluria: A Case Report and Review of the Literature

Star Fruit Intoxication

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