Traditional Herbal Preparations and Acute Renal Failure in South West Nigeria

Fifty-three cases (36 men; mean age 30.2 ± 9.5 years) of acute renal failure (ARF) in which traditional herbal preparations were implicated were seen over a 10-year period. The preparations had been taken to treat a febrile illness (38 cases), abdominal upset (seven cases) and for no clear reason (five cases). Vaginal pessaries had been used to induce abortion in two cases and for infertility in one case. The few identified plant materials included leaves and bark of the mango (Mangifera indica), shoots of cashew leaves (Anacardium occidentale), paw-paw leaves (Carica papaya), lime-leaves (Citrus aurantifolia), Solanium erianthum, Morinda lucida leaves and bark, Azadirachta indica leaves. The major presenting features were oliguria or anuria (41); jaundice (39); and anaemia (25). Oliguria occurred 3.5 ± 0.7 days after the ingestion of the herbs. The picture was consistent with acute tubular necrosis in all the cases and the mechanisms were: by intravascular haemolysis (34); hepatotoxicity (5); and presumably direct nephrotoxicity (14). Forty-five patients received dialysis and three deaths were recorded. These cases of ARF could have been prevented by proper education and awareness. © 1999, SAGE Publications. All rights reserved.