Star Fruit - No Good for Kidneys?

Star fruit is not safe for any patient with chronic kidney disease.

1. Star fruit is a popular fruit in tropical and subtropical countries and its consumption is high in Asia. Multiple case series have reported its nephro-and neurotoxicity in CKD patients as well as in people with normal renal function.

2. The amount of fruit ingested which causes toxicity is related poorly to severity of symptoms. In cases of moderate to severe intoxication, neuropsychiatric manifestations can occur and may progress rapidly to coma and refractory status epilepticus, resulting in death.

3. Star fruit nephrotoxicity is believed to be due to its high oxalate content which could cause acute obstructive tubular nephropathy. Prompt treatment with intensified hemodialysis and hemoperfusion, close monitoring and supportive care has been propsed as an effective therapeutic approach.

I have highlighted this previously in a letter to Clinical Medicine (RCP Journal), and it was cited in a review for kidney toxicity due to herbs and dietary supplements in Food and Chemical Toxicology journal.

Full text:
KG Lee. Star fruit intoxication with acute kidney injury. Clinical Medicine 2012; 12:494