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    « Mend the Gap - Schatell's comments to CMS and the renal community | Main | Medicare shouldn't use race/ethnicity as a case mix adjuster »

    October 25, 2009

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    We saw a case of this during my 1st year of nephrology fellowship--we were consulted on a 58 yo M with a history of stage 3 CKD--who developed altered mental status requiring intubation. We were consulted to rule out "uremia" as a cause of his delta MS, though his BUN was only in the 50s and not that off from his baseline. It turns out the patient had been on a cruise during which he had consumed some starfruit at a buffet. His altered mental status improved rapidly following 2-3 sessions of dialysis.

    Miriam Lippel Blum

    Interesting case. Thanks for sharing. Starfruit can be deadly for those with advanced CKD and it turns up in fruit salads and other places sometimes so it is worth asking what is in things before one eats them.

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