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|Tuanku Ja'afar Hospital, Malaysia|
|ScientificTracks Abstracts: J Nephrol Ther|
|Djenkol beans (Pithecellobium jiringa) are frequently used in the Malay Archipelago in local cuisine. It contains djenkolic acid which precipitates in urine forming sludge, causing obstructive uropathy. Djenkolism has been reported exclusively involving the South East Asian population, principally Malaysians and Indonesians. We present two cases of djenkolism. A healthy 28 year old Indonesian gentleman presented with difficulty in passing urine and haematuria hours after consuming 20 beans of djenkol. He had an initial urea of 6.5 mmol/L, potassium 4.1 mmol/L and creatinine 274 μmol/L. The peak urea was 13.4 mmol/L, potassium 5.0 mmol/L and creatinine 430 μmol/L, without metabolic acidosis. An ultrasound noted bilateral hydronephrosis and hydroureter. A CT urogram revealed mild left hydronephrosis and hydroureter with no calculi. With hydration, the renal profile improved and he was discharged after seven days with normal kidney function. The second case was a healthy 44 year old Indonesian gentleman who presented with inability to pass urine 48 hours after consuming a kilogram of djenkol beans. He had an initial urea of 14.8 mmol/L, potassium 4.3 mmol/L and creatinine 443 μmol/L. The peak urea was 27.1 mmol/L and creatinine 1088 μmol/L with compensated metabolic acidosis. An ultrasound and CT urogram revealed mild right hydronephrosis but no calculi. He was anuric despite aggressive hydration. Hemodialysis was performed twice. He later developed frank haematuria and became polyuric. He was discharged well after seven days with resolution of acute kidney injury. This is believed to be the first report of djenkolism requiring acute dialysis.|
Sudhaharan Sivathasan is a Consultant Physician and Nephrologist at Tuanku Ja'afar Hospital, Malaysia. He completed his Graduation at University of Malaya. He subsequently completed his Membership of the Royal Colleges of Physicians of the United Kingdom and Board of Nephrology Fellowship (Malaysia). He is a member of Academy of Medicine of Malaysia and Malaysian Society of Nephrology. His interests include Hemodialysis and General Nephrology. He has published papers, and also reviewed articles for journals. He is an honorary Lecturer at International Medical University and a guest Lecturer at Perdana University.
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