• Miguel Moyses-Neto, Bruno Rafael Santos Brito, de Araújo BritoDyego JoséDJKidney Disease Prevention Centre and University Hospital, Federal University of Maranhão, Barão de Itapary Street, 227, Centro, São Luís, MA, 65020-070, Brazil., Noelia Dias Carneiro Barros, Márcio Dantas, Natalino Salgado-Filho, Roberto Silva Costa, and Gyl Eanes Barros Silva.
• Nephrology Division, Department of Internal Medicine, Ribeirão Preto Medical School, University of São Paulo, Av. Bandeirantes, 3900 - Monte Alegre, Ribeirão Preto, SP, 14049-900, Brazil.
• Bmc Nephrol. 2018 Oct 12; 19 (1): 265.

BackgroundIngestion of vitamin C is generally regarded as harmless. Oxalate nephropathy is an infrequent condition and is characterized by oxalate deposition in the renal tubules, in some cases resulting in acute kidney injury. It can be caused by overproduction of oxalate in genetic disorders and, more frequently, as a secondary phenomenon provoked by ingestion of oxalate or substances that can be transformed into oxalate in the patient.Case PresentationWe present a case of acute oxalate nephropathy in a 59-year-old black male with type 2 diabetes mellitus, who received a kidney transplant 11 years prior. He ingested a large amount of cashew pseudofruit ("cashew apple") during 1 month and developed acute kidney injury. His previous blood creatinine was 2.0 mg/dL, which increased to 7.2 mg/d; he required hemodialysis. He was subsequently discharged without need for dialysis; 3 months later his blood creatinine stabilized at 3.6 mg/dL.ConclusionsThis pseudofruit is rich in ascorbic acid (vitamin C) and poor in oxalate. Urinary oxalate excretion begins to increase when amounts of ascorbic acid above bodily requirements are ingested, and may provoke acute oxalate nephropathy. The patient's oxalate acute nephropathy, in this case, was attributed to excessive vitamin C ingestion from the cashew pseudofruit associated with decreased renal function.

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