End stage renal disease: A dreaded complication of the use of a Chinese herb
Cordova, H.R.; Troche, R.; Rosado-Rodriguez, C.
Boletin de la Asociacion Medica de Puerto Rico 97(2): 153-157
2005
ISSN/ISBN: 0004-4849 Document Number: 703045
59 year-old man with a history of peptic ulcer disease and hypertension, complained of nausea, bad taste, general malaise, decreased appetite, increased urinary frequency and thirst during the month prior to evaluation. The patient referred longstanding use of natural herbs. Physical exam was relevant for the presence of bilateral leg edema. Kidney Sonogram failed to show obstruction, and the kidneys size were normal. Laboratories on admission showed: Creatinine, 7.9 mg/dL; BUN, 66.5 mg/dL. Urinalysis showed 4+ protein, mild pyuria but no red blood cell casts. The initial diagnostic impression was that of acute glomerular disease. Therefore, a kidney biopsy was done which showed acute and chronic tubulointerstitial inflammation with fibrosis and diffuse global glomerulosclerosis. Further serologic workup was negative. The patient required chronic hemodialysis. The clinical picture and kidney biopsy findings suggested that the renal failure was due to the use Chinese herbs contaminated with aristolochic acid.
Document emailed within 1 workday
