Hugo Abensur
1, Karina dos Santos Falani
1, Roberto Buessio
1, Fabiana Toledo Bueno
2, Dino Martini Filho
2, Maria Regina Teixeira Araújo
1, Joao Egidio Romao Junior
1*1 Clínica de Nefrologia e Transplantes, Hospital da Beneficência Portuguesa, São Paulo, Brazil
2 Serviço de Patologia, Hospital da Beneficência Portuguesa, São Paulo, Brazil
Abstract
Background: Great quantity of star fruit (Averrhoa carambola) ingestion, or even smaller
amounts in a patient with an empty stomach, may induce acute kidney injury (AKI).
Case Presentation: We report a 65-year-old male patient with underlying multiple myeloma
and normal kidney function, who developed alterations of consciousness and rapid
increase in serum creatinine due to oxalate nephropathy after large ingestion of star fruit
on an empty stomach. Kidney biopsy revealed the diagnosis of oxalate nephropathy.
Conclusions: AKI due to oxalate nephropathy after star fruit ingestion is relatively uncommon
(only eight other reported cases) but there is an increasing evidence of AKI associated with
intoxication by star fruit. This case alerts health professionals, nephrologists in particular,
to a new disease that is increasingly better known and diagnosed more frequently
Implication for health policy/practice/research/medical education:
Star fruit (carambola) is cultivated in many tropical and subtropical areas, especially in Southeast Asia and South and Central
America. Star fruit nephrotoxicity in people with normal renal function is rarely reported. However, this case reported of acute
oxalate nephropathy induced by large ingestion of star fruit. Along with those previously reported, confirm the existence of
this disease, and is a reason to alert health professionals in these regions.
Please cite this paper as: Abensur H, Falani KDS, Buessio R, Bueno FT, Filho DM, Teixeira Araújo MR, Romão Junior JE.
Acute kidney injury due to oxalate nephropathy after star fruit ingestion. J Nephropathol. 2018;7(4):290-292. doi: 10.15171/
jnp.2018.57