A case report of chronic interstitial nephritis associated with Chinese herbal supplement Zi Xiu Tang Bee Pollen

We report a case of renal failure associated with ingestion of Chinese herbal weight loss supplement called Zi Xiu Tang Bee Pollen. A 33 year old African American female who had been ingesting Zi Xiu Tang Bee Pollen for about one year in duration. The patient presented to our facility with renal failure requiring dialysis for one month from unknown etiology. The patient had a normal creatinine level a few months prior to starting dialysis. The patient had no additional medical history. Her urine studies were positive for sterile pyuria, suggestive of interstitial nephritis. She subsequently underwent a kidney biopsy which showed severe chronic interstitial nephritis due to Zi Xiu Tang Bee Pollen. The Chinese herbal supplement was discontinued, but patient remained dialysis dependent. Our literature search showed one other reported case of bee pollen associated with acute interstitial nephritis that required short term hemodialysis with renal recovery after discontinuation of supplement. This unique case highlights the growing health risks posed by nonprescription diet supplements and they can potentially add to the increasing burden of kidney disease.