Kidney Week

Abstract: PUB462

Libido Enhancing Herbal Supplementation-Induced Acute Interstitial Nephritis

Session Information

• Publication Only

Category: Trainee Case Report

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Motazedi, Tina, Baylor College of Medicine, Houston, Texas, United States

Tina Motazedi,

• Shah, Anita, Baylor College of Medicine, Houston, Texas, United States

Anita Shah,

• Anumudu, Samaya Javed, Baylor College of Medicine, Houston, Texas, United States

Samaya Javed Anumudu,

Introduction

Acute interstitial nephritis (AIN) results from kidney injury characterized by inflammation in the kidney interstitium, often in the setting of exposure to offending medications^1,2. We report a case of AIN in a healthy male after routine colonoscopy with exposure to multiple non-prescribed herbal medications.

Case Description

A 52-year-old previously healthy male on multiple herbal supplements including black maca, Tongkat Ali extract, Mucuna extract, and saw palmetto to increase libido presented to the hospital with acute kidney injury (AKI) approximately one month after a routine screening colonoscopy. The patient had no known kidney disease prior to his procedure. Post colonoscopy, he developed right sided flank pain followed by weight loss and anorexia. Labs were notable for creatinine of 4.06 mg/dL, Urinalysis with glucosuria, proteinuria and moderate leukocytes, with rare eosinophils in the urine. Renal ultrasound showed normal kidney sizes. Kidney biopsy was consistent with acute allergic interstitial nephritis, with mild interstitial fibrosis or tubular atrophy. Kidney function improved with cessation of all herbal supplements and treatment with prednisone.

Discussion

This case illustrates a rare cause of acute interstitial nephritis induced from herbal supplements and to the best of our knowledge has not been well reported in the literature. There is little known about the safety profile of these medications and the mechanism in which they induce such injury. Thorough history taking is imperative on part of clinicians to be able to identify these medications (that are often not reported initially), especially by nephrologists in settings where kidney injury cannot be explained by other processes. This allows for early diagnosis, kidney biopsy if possible, avoidance of future use of the medications, and prompt initiation of treatment in hopes to prevent long-term kidney damage.