Background: Averrhoa bilimbi is a commonly used fruit in South India for various home
preparations and as a traditional remedy for hypercholesterolemia and hypertension. As
it belongs to Oxalidaceae family, fruit has high oxalate content, causing calcium oxalate
crystal deposition in renal tubules, resulting in acute oxalate nephropathy (AON) when
consumed in large quantities.
Case Series: We present a series of 24 patients from 11 hospitals in the State of Kerala
who developed acute renal failure after some days of intake of Irumban puli fruit juice.
Seven patients needed hemodialysis while the other three improved with conservative
Conclusions: We conclude that it is not safe to consume high oxalate containing fruits,
especially in concentrated forms, that too in large quantities.