Rapidly progressive interstitial renal fibrosis due to a chronic intake of a herb (Aristolochia pistolochia) infusion

An outbreak of rapidly progressive renal failure was observed in Belgium in 1992-1993 and was related to a slimming regimen involving Chinese herbs [1]. Extensive interstitial fibrosis with atrophy and tubular loss was the major histological lesion [2]. Aristolochia Fang-ji has been suspected to be responsible for nephrotoxicity, which is attributed to aristolochic acid, an important constituent of Aristolochia spp. [3,4]. We report a patient presenting with end-stage renal failure due to chronic intake of an infusion made with a mixture of herbs containing Aristolochia pistolochia. Clinical and histological findings are identical to the Belgian cases.