Tags

Type your tag names separated by a space and hit enter

Star fruit nephrotoxicity: a case series and literature review.
BMC Nephrol. 2018 10 22; 19(1):288.BN

Abstract

BACKGROUND

Star fruit is a popular medicinal fruit in the tropics. Its hypoglycaemic properties are considered useful in achieving glycaemic control in diabetes. Star fruit induced nephrotoxicity is a rare cause of acute kidney injury in individuals with both normal and reduced baseline renal function. We present three cases of acute kidney injury due to star fruit nephrotoxicity from Sri Lanka, and discuss the published literature on this topic.

CASE PRESENTATION

Three Sri Lankan patients, all with a background of diabetes, presented to us with acute nausea and anorexia following recent consumption of star fruit. Two patients complained of diarrhoea and one patient complained of intractable hiccoughs. They all had elevated serum creatinine on admission. Two were known to have normal baseline serum creatinine levels. On renal biopsy two had evidence of oxalate crystal deposition. One did not show crystal deposition but had acute interstitial nephritis for which no alternate cause could be identified. Two were treated with short courses of prednisolone and two required acute haemodialysis. All recovered renal function, with both patients with known baselines approaching their premorbid serum creatinine levels.

CONCLUSION

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.

Authors+Show Affiliations

Univeristy Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka. dilushi_w@yahoo.com.Nephrology, Dialysis and Transplant Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.Department of Pathology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.Nephrology, Dialysis and Transplant Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka.Univeristy Medical Unit, National Hospital of Sri Lanka, Colombo, Sri Lanka. Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka.

Pub Type(s)

Case Reports
Journal Article
Review

Language

eng

PubMed ID

30348106

Citation

Wijayaratne, Dilushi Rowena, et al. "Star Fruit Nephrotoxicity: a Case Series and Literature Review." BMC Nephrology, vol. 19, no. 1, 2018, p. 288.
Wijayaratne DR, Bavanthan V, de Silva MVC, et al. Star fruit nephrotoxicity: a case series and literature review. BMC Nephrol. 2018;19(1):288.
Wijayaratne, D. R., Bavanthan, V., de Silva, M. V. C., Nazar, A. L. M., & Wijewickrama, E. S. (2018). Star fruit nephrotoxicity: a case series and literature review. BMC Nephrology, 19(1), 288. https://doi.org/10.1186/s12882-018-1084-1
Wijayaratne DR, et al. Star Fruit Nephrotoxicity: a Case Series and Literature Review. BMC Nephrol. 2018 10 22;19(1):288. PubMed PMID: 30348106.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Star fruit nephrotoxicity: a case series and literature review. AU - Wijayaratne,Dilushi Rowena, AU - Bavanthan,V, AU - de Silva,M V C, AU - Nazar,A L M, AU - Wijewickrama,Eranga S, Y1 - 2018/10/22/ PY - 2017/11/05/received PY - 2018/10/08/accepted PY - 2018/10/24/entrez PY - 2018/10/24/pubmed PY - 2019/9/13/medline KW - Acute kidney injury KW - Oxalate KW - Star fruit SP - 288 EP - 288 JF - BMC nephrology JO - BMC Nephrol VL - 19 IS - 1 N2 - BACKGROUND: Star fruit is a popular medicinal fruit in the tropics. Its hypoglycaemic properties are considered useful in achieving glycaemic control in diabetes. Star fruit induced nephrotoxicity is a rare cause of acute kidney injury in individuals with both normal and reduced baseline renal function. We present three cases of acute kidney injury due to star fruit nephrotoxicity from Sri Lanka, and discuss the published literature on this topic. CASE PRESENTATION: Three Sri Lankan patients, all with a background of diabetes, presented to us with acute nausea and anorexia following recent consumption of star fruit. Two patients complained of diarrhoea and one patient complained of intractable hiccoughs. They all had elevated serum creatinine on admission. Two were known to have normal baseline serum creatinine levels. On renal biopsy two had evidence of oxalate crystal deposition. One did not show crystal deposition but had acute interstitial nephritis for which no alternate cause could be identified. Two were treated with short courses of prednisolone and two required acute haemodialysis. All recovered renal function, with both patients with known baselines approaching their premorbid serum creatinine levels. CONCLUSION: 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. SN - 1471-2369 UR - https://www.unboundmedicine.com/medline/citation/30348106/Star_fruit_nephrotoxicity:_a_case_series_and_literature_review_ L2 - https://www.biomedcentral.com/1471-2369/19/288 DB - PRIME DP - Unbound Medicine ER -