Star fruit as a cause of acute kidney injury

A carambola pertence a familia das Oxalidaceas, especie Averrhoa carambola. E rica em sais minerais, vitaminas A, C, complexo B e acido oxalico. Estudos recentes demonstram que a toxicidade da fruta difere entre os individuos e pode ser explicada pelas respostas biologicas individuais como idade, quantidade da ingestao, neurotoxinas em cada tipo de fruta. Adicionalmente, a nefrotoxicidade causada pela fruta e dose dependente, podendo levar ao desenvolvimento de lesao renal aguda pela deposicao de cristais de oxalato de calcio intratubular, assim como por lesao direta das celulas epiteliais tubulares, levando a apoptose das mesmas. Relatamos o caso de uma paciente que, apos a ingestao do suco da fruta e fruta in natura, desenvolveu lesao renal aguda, necessitando de terapia dialitica, evoluindo com desfecho favoravel e recuperacao da funcao renal. Resumo The star fruit belongs to the family Oxalidacea, species Averrhoa carambola. It is rich in minerals, vitamin A, C, B complex vitamins and oxalic acid. Recent studies show that the toxicity of the fruit differs between the patients and may be explained by single biological responses, age, and the intake quantity of the neurotoxin in each fruit in addition to glomerular filtration rate given by each patient. Additionally, the nephrotoxicity caused by the fruit is dose-dependent and may lead to the deposition of crystals of calcium oxalate intratubular, as well as by direct injury to the renal tubular epithelium, leading to apoptosis of the same. We report the case of a patient who after ingestion of the juice and fresh fruit, developed acute renal failure requiring dialysis, evolving with favourable outcome and recovery of renal function.