ASN's Mission

ASN leads the fight to prevent, treat, and cure kidney diseases throughout the world by educating health professionals and scientists, advancing research and innovation, communicating new knowledge, and advocating for the highest quality care for patients.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on Twitter

Kidney Week

Abstract: PO1196

Annatto Leaf Tea Intoxication: An Unusual Cause of Green Urine

Session Information

Category: Fluid, Electrolyte, and Acid-Base Disorders

  • 902 Fluid, Electrolyte, and Acid-Base Disorders: Clinical

Authors

  • Valle, Eduardo de Oliveira, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Ribeiro, Rayra Gomes, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Gorzoni, João Lucas Martins, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Santa Catharina, Guilherme P., Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Reichert, Bernardo V., Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Arantes de Oliveira, Marcia Fernanda, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Seabra, Victor F., Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Lins, Paulo Ricardo Gessolo, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Smolentzov, Igor, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Rodrigues, Camila Eleuterio, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
  • Andrade, Lucia, Hospital das Clinicas, University of Sao Paulo School of Medicine, Sao Paulo, Sao Paulo, Brazil
Introduction

The roots and leaves of the annatto ("urucu") tree (Bixa Orellana) are used by the lay population in the treatment of many diseases. We describe a case of AKI with severe fluid and electrolyte (F+E) imbalance due to annatto leaf tea use.

Case Description

A 59-year-old male without known comorbidities presented with a 2-week history of severe diarrhea. Three days prior to admission, he was diagnosed with renal dysfunction, received 500 mL of saline and was discharged. Subsequently, he presented with muscle weakness, uremic encephalopathy, severe AKI, F+E imbalance and greenish urine (Figure). He received fluid resuscitation and underwent two sessions of hemodialysis. He reported having ingested annatto leaf tea to treat his diarrhea. Blood and urine cultures were negative and there was no history of drug use. He was discharged on day 14 with no remaining F+E imbalance or renal dysfunction.

Discussion

The diuretic effect of annatto leaf extracts has been shown in experimental models. To our knowledge, this is the first report of severe AKI and F+E imbalance due to annatto leaf tea use. In our patient, AKI was aggravated by the diarrhea and the diuretic effect of the tea.

Table 1.
 AdmissionDischargeReference range
Hemoglobin (mg/dL)17.311.613.5 - 17.5 g/dL
Serum creatinine (mg/dL)8.090.790.7 - 1.2 mg/dL
Urea (mg/dL)5022310 - 50 mg/dL
Sodium (mEq/L)111136135 - 145 mEq/L
Potassium (mEq/L)4.84.63.5 - 5 mEq/L
Chloride (mEq/L)559998 - 107 mEq/L
Magnesium (mg/dL)2.991.71.58 - 2.55 mg/dL
Phosporus (mg/dL)20.52.52.7 - 4.5 mg/dL
Ionizide calcium (mg/dL)3.154.924.49 - 5.29 mg/dl
Uric acid (mg/dL)25.52.93.4 - 7 mg/dl
pH7.277.467.35 - 7.45
Bicarbonate (mmol/L)1222.523 - 27 mmol/L