Djenkol Bean Research Articles

Acute kidney injury in the tropics.

The tropics are a region consisting of more than 125 countries, accounting for 40% of the world's population. The region's population is expected to increase up to 60% in the coming decades. Many tropical countries continue to experience public health problems such as high rates of infectious diseases, lack of sanitation, climate change impacts, poor regulation of herbal medicines and low access to healthcare. These conditions produce the unique problem of tropical acute kidney injury (AKI), which is associated with high morbidity and mortality. Tropical infections such as leptospirosis, dengue and malaria have varied mechanisms of AKI, including both direct kidney invasion and indirect effects, depending on the disease characteristics. Animal toxins from snakebites and arthropods along with plant toxins, such as djenkol beans, starfruit and herbal medicine, are characterized by a harmful renal effect from each toxic substance. Environmental factors such as heat stress, natural disasters and chemical compounds also lead to AKI and have a systemic effect from their own pathogenesis. The long-term kidney prognosis varies among these etiologies depending on the cause and severity of disease. However, all these conditions are potentially preventable and treatable. Prompt management and good preventive approaches are needed. This article will focus on the epidemiology, pathogenesis and management of AKI associated with tropical infections, toxins and environment impacts.

Acute kidney injury in patient with djenkolism: a case report

Background: Djenkolic poisoning or djenkolism is one of the causes of acute kidney failure common in Southeast Asia. Djenkol bean or jering (Archidendron pauciflorum) is one of the foods commonly found in Southeast Asia. These seed plants are usually processed by boiling or frying, but often they are also consumed raw. Djenkolism sometimes occurs, albeit infrequently after ingesting djenkol beans. The clinical presentation of djenkolism is varied but generally presents as a spasmodic loin to groin pain and acute kidney injury (AKI), with evidence of urinary obstruction.Case description: We report a previously healthy 40-year-old male developed AKI after consuming a large amount of uncooked djenkol beans, which was resolved with rehydration with normal saline and conservative therapy.Conclusion: We highlight the importance of healthcare practitioners, especially in the Southeast Asian region to consider this rare cause of acute kidney injury to provide early diagnosis and prompt treatments.

The Social Economic Aspect in Selecting Priority Commodities in Community Forest Activities at Protected Forest Areas

The implementation of Community Forestry (CF) in protected forest area is not only intended to improve welfare of community living around forest but also restores the function of protected areas. This study aims to figure out the types of priority crops that can be developed in CF area based on legal aspect of the rules in protected forest areas and social economic aspect of community surround forest areas. The research was conducted for 4 months, on February – May 2020 in working areas of Meranti Wana Makmur Forest Farmers Group (Gapoktanhut), Lubuk Bintialo Village, Batanghari Leko District, Musi Banyuasin Regency. The result showed that according to provisions of utilization in protected forest areas, the types of crops which developed in the CF area, were multipurpose crops and based on social aspects 5 (five) types of crops that had grown and produced were Rubber, Jackfruit, Djenkol bean, Petai bean, and Durian was in “Fairly Priority” category. Therefore, based on the economic aspect, there were only 4 (four) multipurpose plant types of “profitable” categories, such as Jackfruit, Djenkol bean, Petai bean, and Durian. The type of short-term crops function as companion crops (intercrops) that was good for cultivation were Corn, Chili, Watermelon, and Melon.

Non-protein amino acids in Australian acacia seed: Implications for food security and recommended processing methods to reduce djenkolic acid

Seed of Australian acacia species, Acacia colei, Acacia elecantha, Acacia torulosa, Acacia turmida and Acacia saligna, were analysed for the presence of toxic non-protein amino acids and the levels of essential amino acids. Amines were derivatised with 6-aminoquinolyl-N-hydroxysuccinimidyl carbamate before analysis using liquid chromatography electrospray ionisation triple quadrupole mass spectrometry (LC-ESI-QQQ-MS). Multiple reaction monitoring (MRM) with optimised transitions and collision energies for each analyte were employed. The known nephrotoxic compound djenkolic acid was found to be present at elevated levels in all species tested. The lowest levels were in A. colei (0.49% w/w) and the highest in A. saligna (1.85% w/w). Observed levels of djenkolic acid are comparable to measured and reported levels found in the djenkol bean. Subsequent testing of seed processing methods showed djenkolic acid levels can be significantly reduced by over 90% by dry roasting at 180°C rendering the seed safe for human consumption.

An alpha-glucosidase inhibitory activity of thermostable lectin protein from Archidendron jiringa Nielsen seeds

Inhibitors of α-glucosidase from natural resources that inhibit the digestion of carbohydrate polymers into monosaccharides in the gut are used in the treatment of insulin-independent diabetes mellitus type 2. Archidendron jiringa belongs to pea family of leguminous plants, some of which are a source of interesting bioactivities, including α-glucosidase inhibitory (GI) activity. A novel GI lectin was enriched from the seeds of the Djenkol bean, A. jiringa , to apparent homogeneity by 90% saturation ammonium sulfate precipitation and Con A-Sepharose affinity column chromatography. This lectin had an IC 50 value for GI activity of 0.031 „b 0.02 mg/ml, an estimated molecular mass of 35.7 kDa, of which 15.8% was carbohydrate, was thermostable up to 80¢XC for 70 min, showed an optimum activity within the pH range of 8.0 to 10.0 and a high activity with some divalent cations such as copper (Cu 2+ ) and high levels (50 to 100 mM) of zinc (Zn 2+ ) and iron (Fe 2+ ). The sequence of an internal 16 amino acid fragment of the protein showed 100% identity to the mannose-glucose specific lectin precursor of Dioclea guainensis. The GI lectin had a high specific interaction with α-glucosidase (affinity constant = 9.3773 „e 10-7 s -1 , Ks = 0.0241 s -1 , Ka = 2.39 „e 103 s -1 M -1 and Kd = 0.0117 M). Key words: Archidendron jiringa, α-glucosidase inhibitors, lectin.

Acute kidney injury in the tropics

Acute kidney injury (AKI) is one of the most challenging problems faced by clinicians in the tropics owing to its fast-changing burden. AKI in the tropics is strikingly different from that in the developed world in terms of etiology and presentation. In addition, there is a stark contrast between well-developed and poor areas in the tropics. The true epidemiological picture of AKI in the tropics is not well understood due to the late presentation of patients to tertiary centers. Infections remain the major culprit in most cases of AKI, with high mortality rates in the tropics. Human immunodeficiency virus–related AKI, related to nephrotoxicity due to antiretroviral therapy, is on the rise. Acute tubular necrosis and thrombotic microangiopathy are the most common mechanisms of AKI. A notable problem in the tropics is the scarcity of resources in health centers to support patients who require critical care due to AKI. This article reviews the unique and contrasting nature of AKI in the tropics and describes its management in each situation.

Acute Anuric Renal Failure Following Jering Bean Ingestion

Djenkol beans or jering (Pithecellobium jeringa) is a traditional delicacy consumed by the local population in Malaysia. Jering poisoning or djenkolism is characterized by spasmodic pain, urinary obstruction and acute renal failure. The underlying pathology is an obstructive nephropathy, which is usually responsive to aggressive hydration and diuretic therapy. We present a case of djenkolism following ingestion of jering. The patient required urgent bilateral ureteric stenting following the failure of conservative therapy. Healthcare providers need to recognize djenkolism as a cause of acute renal failure and the public educated on this potential health hazard.

Nephropathy Associated With Animal, Plant, and Chemical Toxins in the Tropics

Widespread human exposure to a variety of drugs, chemicals, and biologic products and recent awareness of their toxic manifestations has led to the recognition of toxic nephropathy as an Important segment of renal disease in the tropical countries. Tropical nephrotoxins are distinctly different from those seen in the rest of the world and are derived from local fauna and flora or plant and chemical sources. The spectrum of exposure varies from country to country and even from community to community, depending on variations in the distribution of local plants and animal species and prevalent social practices. Acute renal failure (ARF), either alone or in association with liver failure, neurologic abnormalities, metabolic acidosis, disseminated intravascular coagulation, or pulmonary infections is the most common form of presentation. Traditional medicines prescribed by witch doctors (traditional healers) constitute a special class of nephrotoxins among several communities in Africa and Asia. The prevalence of nephropathy caused by traditional medicines is directly related to a combination of ignorance, poverty, lack of medical facilities, lax legislation, and widespread belief in indigenous systems of medicine in rural areas. These medicines are a mix of herbs and unknown chemicals administered orally or as enemas. Clustering of cases after exposure to a particular agent suggests the possibility of a toxic insult. Common animal nephrotoxins are venoms of viper snakes, sea snakes, stinging insects, and raw gallbladder and bile of carp and sheep. Botanical nephrotoxins are encountered both in common edible plants (djenkol beans, mushrooms) and medicinal herbs (impila, cat's claw). Mistaken identification of medicinal herbs by untrained workers and even deliberate trials of toxic substitutes derived from plants frequently lead to renal disease, the most commonly reported being the Chinese herbal nephropathy. Nephrotoxicity caused by chemicals can be secondary to accidental occupational exposure in industrial work places (eg, chromic acid), or after suicidal or homicidal use (eg, copper sulphate, ethylene dibromide, ethylene glycol). Late presentation and multiorgan dysfunction are associated with a high mortality. A high index of suspicion, careful history taking, and an awareness of local practices are essential for proper diagnosis and management of toxic nephropathies in the tropics. Widespread human exposure to a variety of drugs, chemicals, and biologic products and recent awareness of their toxic manifestations has led to the recognition of toxic nephropathy as an Important segment of renal disease in the tropical countries. Tropical nephrotoxins are distinctly different from those seen in the rest of the world and are derived from local fauna and flora or plant and chemical sources. The spectrum of exposure varies from country to country and even from community to community, depending on variations in the distribution of local plants and animal species and prevalent social practices. Acute renal failure (ARF), either alone or in association with liver failure, neurologic abnormalities, metabolic acidosis, disseminated intravascular coagulation, or pulmonary infections is the most common form of presentation. Traditional medicines prescribed by witch doctors (traditional healers) constitute a special class of nephrotoxins among several communities in Africa and Asia. The prevalence of nephropathy caused by traditional medicines is directly related to a combination of ignorance, poverty, lack of medical facilities, lax legislation, and widespread belief in indigenous systems of medicine in rural areas. These medicines are a mix of herbs and unknown chemicals administered orally or as enemas. Clustering of cases after exposure to a particular agent suggests the possibility of a toxic insult. Common animal nephrotoxins are venoms of viper snakes, sea snakes, stinging insects, and raw gallbladder and bile of carp and sheep. Botanical nephrotoxins are encountered both in common edible plants (djenkol beans, mushrooms) and medicinal herbs (impila, cat's claw). Mistaken identification of medicinal herbs by untrained workers and even deliberate trials of toxic substitutes derived from plants frequently lead to renal disease, the most commonly reported being the Chinese herbal nephropathy. Nephrotoxicity caused by chemicals can be secondary to accidental occupational exposure in industrial work places (eg, chromic acid), or after suicidal or homicidal use (eg, copper sulphate, ethylene dibromide, ethylene glycol). Late presentation and multiorgan dysfunction are associated with a high mortality. A high index of suspicion, careful history taking, and an awareness of local practices are essential for proper diagnosis and management of toxic nephropathies in the tropics.

Nephropathy associated with animal, plant, and chemical toxins in the tropics.

Widespread human exposure to a variety of drugs, chemicals, and biologic products and recent awareness of their toxic manifestations has led to the recognition of toxic nephropathy as an important segment of renal disease in the tropical countries. Tropical nephrotoxins are distinctly different from those seen in the rest of the world and are derived from local fauna and flora or plant and chemical sources. The spectrum of exposure varies from country to country and even from community to community, depending on variations in the distribution of local plants and animal species and prevalent social practices. Acute renal failure (ARF), either alone or in association with liver failure, neurologic abnormalities, metabolic acidosis, disseminated intravascular coagulation, or pulmonary infections is the most common form of presentation. Traditional medicines prescribed by witch doctors (traditional healers) constitute a special class of nephrotoxins among several communities in Africa and Asia. The prevalence of nephropathy caused by traditional medicines is directly related to a combination of ignorance, poverty, lack of medical facilities, lax legislation, and widespread belief in indigenous systems of medicine in rural areas. These medicines are a mix of herbs and unknown chemicals administered orally or as enemas. Clustering of cases after exposure to a particular agent suggests the possibility of a toxic insult. Common animal nephrotoxins are venoms of viper snakes, sea snakes, stinging insects, and raw gallbladder and bile of carp and sheep. Botanical nephrotoxins are encountered both in common edible plants (djenkol beans, mushrooms) and medicinal herbs (impila, cat's claw). Mistaken identification of medicinal herbs by untrained workers and even deliberate trials of toxic substitutes derived from plants frequently lead to renal disease, the most commonly reported being the Chinese herbal nephropathy. Nephrotoxicity caused by chemicals can be secondary to accidental occupational exposure in industrial work places (eg, chromic acid), or after suicidal or homicidal use (eg, copper sulphate, ethylene dibromide, ethylene glycol). Late presentation and multiorgan dysfunction are associated with a high mortality. A high index of suspicion, careful history taking, and an awareness of local practices are essential for proper diagnosis and management of toxic nephropathies in the tropics.

Tropical plant‐associated nephropathy

SUMMARY: In the tropical area, nephrotoxicity can be caused by certain plants or plant materials. These include djenkol bean, mushroom, Callilepis laureola, Semicarpus anacardium, Securidaca longipe dunculata and Vicis favus. Djenkol beans consumed by people in South‐east Asia can cause toxicity or djenkolism. Renal manifestrations of djenkolism include dysuria, hematuria, proteinuria, urolithiasis, and acute renal failure. Djenkolic acid in the bean can cause renal dysfunction by mechanical irritation of djenkolic acid crystals and by direct toxicity. Renal involvement in mushroom poisoning is generally caused by certain species of Amanita and Galerina. Amanita toxins produced by such mushrooms could exhibit their toxic effects on several metabolic pathways of all eukaryotic cells including hepatocytes and renal cells. Renal failure is severe with a high mortality rate. Phenolic compounds in the sap of Semecarpus anacrdium, the marking‐nut tree of India, can cause renal failure following prolonged exposure to the sap. Atractyloside, an alkaloid found in the tuber of Callilepis laureola, can cause hypoglycemia and nephrotoxicity. Gaultherin, an amorphous steroid glucoside found in Securidaca longipe dunculata, can cause extensive damage to the kidney. Divicine and isouramil found in Vicis favus, broad bean, can trigger hemolysis in certain subjects with G‐6 PD deficiency, resulting in reversible acute renal failure. Gossypol, the principal ingredient of cotton seed oil, could cause distal renal tubular acidosis.

Djenkol beans as a cause of hematuria in children.

Djenkolism is djenkol bean poisoning, characterized by acute renal failure, urinary obstruction and spasmodic pain. The effects of djenkol bean consumption on the urinary tract without overt symptoms and long-term outcome are not established. This paper examines the association between djenkol bean ingestion and urine abnormalities in school children. 609 school children aged 7-11 years in five urban Hat-Yai schools were interviewed, and had their urine analyzed. All children included in the study had normal blood pressure for age, no illness (including respiratory tract symptoms) and were not taking medication. 78% of the children had a history of eating djenkol bean and of these 31% had done so in the past 24 h. Children with hematuria were almost four times (crude odds ratio = 3.7) as likely to have a history of eating djenkol beans as those with normal urine. Crystaluria and pyuria were not significantly more common among those eating the beans. The risk of having hematuria did not change with increasing consumption, or time since last eaten, or type of preparation even after adjustment for sex and age. Djenkol bean consumption may be defined as one of the probable causes of hematuria in the area where the djenkol tree grows.

Djenkol bean poisoning (Djenkolism): An unusual cause of acute renal failure

This report describes a patient with acute renal failure that resulted from the ingestion of djenkol beans. Features of acute djenkolism include nausea, vomiting, bilateral loin pain, gross hematuria, and oliguria. The blood urea level was 16.2 mmol/L and the serum creatinine was 460 μmol/L. Phase contrast microscopy of the urinary sediment indicated that the hematuria was nonglomerular. Ultrasound of the kidneys showed slightly enlarged kidneys with no features of obstruction. Renal biopsy showed acute tubular necrosis similar to the single animal study reported in the literature. With conservative therapy, which included rehydration with normal saline and alkalinization of the urine with sodium bicarbonate, the acute renal failure resolved. Based on its chemistry, djenkol bean-associated acute renal failure may be analogous to acute uric acid nephropathy.

Marked formation of thioproline, an effective nitrite trapping agent in vivo, in boiled djenkol beans (Indonesian edible beans)

Marked formation of thioproline, an effective nitrite trapping agent in vivo, in boiled djenkol beans (Indonesian edible beans)

Djenkol bean nephrotoxicity: a preliminary survey in southern Thailand: S. Eiam-Ong and V. Sitprija (Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand)

Djenkol bean nephrotoxicity: a preliminary survey in southern Thailand: S. Eiam-Ong and V. Sitprija (Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand)

Djenkol bean poisoning (djenkolism); a cause of hematuria and anuria.

Djenkol bean poisoning (djenkolism); a cause of hematuria and anuria.