Abstract
Averrhoa bilimbi (Irumban puli) is commonly used in South India for variety of household preparations and also as a remedy for hypertension, diabetes and dyslipidemia. The fruit has very high oxalate content which, when consumed in large quantities, forms calcium oxalate crystals in the renal tubules. These crystals get adhered to the tubular cells and cause cell necrosis resulting in acute kidney injury. We describe a series of 4 such cases who presented to us in acute renal failure after consumption of Averrhoa bilimbi in excess. 3 out of 4 patients required hemodialysis. There was recovery of renal function at the end of 2-6 weeks.
Highlights
Averrhoa bilimbi is one of the important medicinal plants of many tropical and subtropical countries of the world
We describe a series of four cases who presented to us with acute kidney injury (AKI) after consumption of Averrhoa bilimbi
Averrhoa bilimbi is used for the treatment of hyperlipidemia, hypertension, and diabetes by different communities [5, 6]
Summary
Averrhoa bilimbi is one of the important medicinal plants of many tropical and subtropical countries of the world. There was no history of fever/ abdominal pain/ loose stools/ decreased urine output He gave history of consumption of Averrhoa bilimbi fruit juice for about 5 days to control the serum cholesterol levels, one week prior to the visit to our centre. On examination, he was afebrile, BP was 140/90 mm Hg, RR: 18/min. Kidney biopsy and hemodialysis were not carried out in view of symptomatic improvement of patient His renal function returned to normal (Serum creatinine: 0.8 mg/dl) at the end of 2 weeks. Kidney biopsy was deferred in view of poor general condition of the patient He showed symptomatic improvement after 2-3 sessions of hemodialysis, urine output slowly improved, chest congestion was relieved and edema started subsiding. Serum creatinine at the end of 6 weeks was 2.3 mg/dl and he was advised regular nephrology follow-up
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