Society of Diabetic Nephropathy Prevention Journal of Nephropathology 2251-8363 7 4 2018 10 01 A case series on Averrhoa bilimbi induced acute oxalate nephropathy; an experience from a tertiary center in Kerala, India 296 300 10.15171/jnp.2018.59 EN Zuhara Shemin Kooloth Mahamoodh Seethalekshmy Nalumackal Vijayan Annie Jojo Journal Article 10.15171/jnp.2018.59 2018 02 08 2018 04 28 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.