A case series on Averrhoa bilimbi induced acute oxalate nephropathy; an experience from a tertiary center in Kerala, India

Zuhara Shemin Kooloth  Mahamoodh; Seethalekshmy Nalumackal Vijayan; Annie Jojo

doi:10.15171/jnp.2018.59

J Nephropathol. 2018;7(4): 296-300.
doi: 10.15171/jnp.2018.59

Scopus ID: 85052393385

Abstract View: 3702

PDF Download: 2135

Case Series

A case series on Averrhoa bilimbi induced acute oxalate nephropathy; an experience from a tertiary center in Kerala, India

Zuhara Shemin Kooloth Mahamoodh ¹^*, Seethalekshmy Nalumackal Vijayan ², Annie Jojo ²

¹ Department of Pathology, MES Medical College, Kerala University of Health Sciences, Perinthalmanna, Kerala, India
² Department of Pathology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India

*Corresponding Author: *Corresponding author: Zuhara Shemin, Email: , Email: zuharasalman@gmail.com

Abstract

Background: Averrhoa bilimbi is a commonly used fruit in South India for various home preparations and as a traditional remedy for hypercholesterolemia and hypertension. As it belongs to Oxalidaceae family, fruit has high oxalate content, causing calcium oxalate crystal deposition in renal tubules, resulting in acute oxalate nephropathy (AON) when consumed in large quantities.

Case Series: We present a series of 24 patients from 11 hospitals in the State of Kerala who developed acute renal failure after some days of intake of Irumban puli fruit juice. Seven patients needed hemodialysis while the other three improved with conservative management.

Conclusions: We conclude that it is not safe to consume high oxalate containing fruits, especially in concentrated forms, that too in large quantities.

Keywords: Acute oxalate nephropathy, Irumban Puli, Averrhoa bilimbi

Implication for health policy/practice/research/medical education:

Irumban Puli (Averrhoa bilimbi) is commonly used as an ingredient of various South Indian dishes. It is also used in various other South East Asian countries for the indigenous method of treatment of diseases like hypertension, diabetes and hypercholesterolemia. Consumption of highly concentrated fruit juice can lead to acute renal failure due to acute tubular necrosis. The high oxalate content leads to Intra-tubular oxalate crystal deposition and renal failure. Hence, we conclude that it is not safe to consume such fruits with high oxalate content, especially in concentrated forms.

Please cite this paper as: Mahamoodh ZSK, Nalumackal Vijayan S, Jojo A. A case series on Averrhoa bilimbi induced acute oxalate nephropathy; an experience from a tertiary center in Kerala, India. J Nephropathol. 2018;7(4):296-300. DOI: 10.15171/ jnp.2018.59.

First Name

Last Name

Email Address

Comments

Security code

Generate New Image

Type the code from the image

Abstract View: 3703

years	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec
2024	13	12	14	19	33	11	16	40	29	33	50	33
2023	49	42	54	52	7	71	61	77	75	73	58	20
2022	46	53	55	39	20	48	33	38	34	46	28	52
2021	51	58	47	41	64	45	49	49	48	48	49	53
2020	40	15	42	59	39	32	43	46	54	56	38	59
2019	54	55	113	130	106	75	63	56	42	52	17	30
2018								17	82	90	95	67

PDF Download: 2135

years	Jan	Feb	Mar	Apr	May	Jun	Jul	Aug	Sep	Oct	Nov	Dec
2024	69	9	7	6	4	5	4	2	18	24	23	29
2023	27	32	19	29	3	26	23	21	19	18	15	10
2022	23	29	32	16	16	8	15	12	19	14	19	20
2021	64	54	46	37	40	28	35	38	43	30	40	30
2020	31	12	25	32	24	20	44	26	53	46	46	34
2019	35	25	39	37	29	23	24	21	18	32	11	16
2018								19	75	73	63	52