Tropical plant‐associated nephropathy

SUMMARY: In the tropical area, nephrotoxicity can be caused by certain plants or plant materials. These include djenkol bean, mushroom, Callilepis laureola, Semicarpus anacardium, Securidaca longipe dunculata and Vicis favus. Djenkol beans consumed by people in South‐east Asia can cause toxicity or djenkolism. Renal manifestrations of djenkolism include dysuria, hematuria, proteinuria, urolithiasis, and acute renal failure. Djenkolic acid in the bean can cause renal dysfunction by mechanical irritation of djenkolic acid crystals and by direct toxicity. Renal involvement in mushroom poisoning is generally caused by certain species of Amanita and Galerina. Amanita toxins produced by such mushrooms could exhibit their toxic effects on several metabolic pathways of all eukaryotic cells including hepatocytes and renal cells. Renal failure is severe with a high mortality rate. Phenolic compounds in the sap of Semecarpus anacrdium , the marking‐nut tree of India, can cause renal failure following prolonged exposure to the sap. Atractyloside, an alkaloid found in the tuber of Callilepis laureola , can cause hypoglycemia and nephrotoxicity. Gaultherin, an amorphous steroid glucoside found in Securidaca longipe dunculata , can cause extensive damage to the kidney. Divicine and isouramil found in Vicis favus , broad bean, can trigger hemolysis in certain subjects with G‐6 PD deficiency, resulting in reversible acute renal failure. Gossypol, the principal ingredient of cotton seed oil, could cause distal renal tubular acidosis.