Acute deterioration of renal function induced by star fruit ingestion in a patient with chronic kidney disease

Star fruit (carambola) is a popular tropical fruit, usually consumed as fresh fruit or as fruit juice. In patients on dialysis, consumption of star fruits can lead to alterations of consciousness. In this case report, we describe a patient with underlying chronic kidney disease, who developed a rapid increase in serum creatinine and oxalate nephropathy after chronic ingestion of star fruit juice without overt neurotoxicity. The decline in renal function was not fully reversible after stoppage. This case demonstrates that star fruit consumption should be considered as a cause of rapid deterioration in renal function in patients with underlying chronic kidney disease that may result in permanent renal injury.