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[Title & authors         ]
Case Reports
Am J Kidney Dis
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. 2018 Feb;71(2):281-286.
doi: 10.1053/j.ajkd.2017.08.002. Epub 2017 Dec 6.

"Green Smoothie Cleanse" Causing Acute Oxalate Nephropathy

Swetha Makkapati^  1 , Vivette D D'Agati^  2 , Leah Balsam^  3
Affiliations Expand

Affiliations

  * ^1 Division of Nephrology, Nassau University Medical Center, East
    Meadow, NY. Electronic address: swetha.makkapa@gmail.com.
  * ^2 Department of Pathology, Columbia University, College of
    Physicians and Surgeons, New York, NY.
  * ^3 Division of Nephrology, Nassau University Medical Center, East
    Meadow, NY.

  * PMID: 29203127
  * DOI: 10.1053/j.ajkd.2017.08.002

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Case Reports

"Green Smoothie Cleanse" Causing Acute Oxalate Nephropathy

Swetha Makkapati et al. Am J Kidney Dis. 2018 Feb.
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Am J Kidney Dis
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. 2018 Feb;71(2):281-286.
doi: 10.1053/j.ajkd.2017.08.002. Epub 2017 Dec 6.

Authors

Swetha Makkapati^  1 , Vivette D D'Agati^  2 , Leah Balsam^  3

Affiliations

  * ^1 Division of Nephrology, Nassau University Medical Center, East
    Meadow, NY. Electronic address: swetha.makkapa@gmail.com.
  * ^2 Department of Pathology, Columbia University, College of
    Physicians and Surgeons, New York, NY.
  * ^3 Division of Nephrology, Nassau University Medical Center, East
    Meadow, NY.

  * PMID: 29203127
  * DOI: 10.1053/j.ajkd.2017.08.002

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Abstract

Oxalate nephropathy is an uncommon condition that causes acute kidney
injury with the potential for progression to end-stage renal disease.
Diagnosis is based on the kidney biopsy findings of abundant
polarizable calcium oxalate crystals in the epithelium and lumen of
renal tubules. We report a case of acute oxalate nephropathy in a
65-year-old woman, temporally associated with the consumption of an
oxalate-rich green smoothie juice "cleanse" prepared from juicing
oxalate-rich green leafy vegetables and fruits. Predisposing factors
included a remote history of gastric bypass and recent prolonged
antibiotic therapy. She had normal kidney function before using the
cleanse and developed acute kidney injury that progressed to
end-stage renal disease. Consumption of such juice cleanses increases
oxalate absorption, causing hyperoxaluria and acute oxalate
nephropathy in patients with predisposing risk factors. Given the
increasing popularity of juice cleanses, it is important that both
patients and physicians have greater awareness of the potential for
acute oxalate nephropathy in susceptible individuals with risk
factors such as chronic kidney disease, gastric bypass, and
antibiotic use.

Keywords: Oxalate; Roux-en-Y gastric bypass (RYGB); acute kidney
injury (AKI); acute oxalate nephropathy (AON); acute renal failure;
crystal; diet; juicing; kidney biopsy; moxifloxacin; spinach;
weight-loss.

Copyright (c) 2017 National Kidney Foundation, Inc. Published by
Elsevier Inc. All rights reserved.

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