Kidney Week

Abstract: SA-PO0332

Synergistic Effect of Garcinia cambogia and Dehydration on Severe AKI with Transient Functional Podocytopathy in an Adolescent

Session Information

• AKI: Case Reports - Drug/Toxin Injury, Crystals, Obstruction, and Unusual Presentations
  October 24, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Heo, Changmin, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)

Changmin Heo, DrMed

• Kim, Yang Wook, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)

Yang Wook Kim, MD, PhD

• Bak, Byeonghwa, Inje University Haeundae Paik Hospital, Busan, Korea (the Republic of)

Byeonghwa Bak, MD, DrMed

Introduction

Garcinia cambogia is a popular weight-loss supplement, yet its potential for severe nephrotoxicity in adolescents is underreported. We report a unique case of a 16-year-old male who developed dialysis-requiring acute kidney injury (AKI) and massive proteinuria following supplement ingestion, highlighting a "double-hit" mechanism of toxic insult and dehydration.

Case Description

A 16-year-old male (BMI: 33.4 kg/m²) presented with nausea and diarrhea after 3 weeks of consuming Garcinia cambogia. Admission labs revealed severe AKI (Peak BUN/Cr 48.1/8.9 mg/dL) and massive proteinuria (UPCR 12.44 g/g). He was diagnosed with concurrent EPEC enterocolitis and required hemodialysis for 7 days. Notably, his proteinuria improved to 84.64 mg/g and renal function recovered rapidly upon supplement withdrawal and hydration, established before the initiation of systemic steroids. Light microscopy showed acute tubular necrosis with mild podocyte swelling and subtle hyaline changes, but without definite segmental sclerosis. Electron microscopy confirmed focal slight foot process effacement without electron-dense deposits. (Fig1) Serum creatinine normalized to 1.18 mg/dL upon discharge.

Discussion

The hallmark of this case is the clinical-pathological dissociation evidenced by severe proteinuria (12.44 g/g) despite minimal glomerular lesions. Rapid resolution to 0.08 g/g upon toxin withdrawal and hydration—prior to any steroid effect—suggests a transient, functional podocytopathy induced by Garcinia cambogia. Furthermore, EPEC enterocolitis likely acted as a "second hit," where dehydration exacerbated the tubular insult. This case underscores that herbal supplements can trigger reversible yet catastrophic renal failure in adolescents, especially when combined with hemodynamic stressors, necessitating prompt discontinuation of the offending agent.

Figure1. Renal Histopathology Findings
A) tubule, B) glomerulus, C) EM