Nephrotoxins in Africa

  • Charles Swanepoel
  • Marc Blockman
  • Joe Talmud

Toxin-induced acute kidney injury (AKI) is a common cause of morbidity and mortality in Africa. However reports in the medical literature are limited because in the majority of cases, identification of the precise toxin is missing [1].

A majority of the toxin induced acute kidney injury in South Africa follows a visit to the traditional diviner (the “ sangoma”). This often results in a conspiracy of silence; the patients are reluctant to admit such a visit and in most instances deny both the consultation, and subsequent ingestion of prescribed herbal therapy [2]. This handicaps the planning of management, particularly as some toxins have multi-system effects, e.g. acute kidney injury accompanied by hepatitis and colitis, as occurs in dichromate poisoning [3]. While the majority of patients admitted with poisoning have been prescribed by traditional healers, approximately 12% of the patients have obtained their medications from “African” shops (equivalent of a western-style chemist) [1]. It is not always the diviner who is responsible for the prescribing these toxins, but rather the patients who buy medicines without completely understanding their content.


Acute Renal Failure Acute Kidney Injury Traditional Healer Membranous Nephropathy Herbal Remedy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Charles Swanepoel
    • 1
  • Marc Blockman
    • 2
  • Joe Talmud
    • 2
  1. 1.Renal Unit (E 13) ObservatoryGroote Schuur HospitalCape TownSouth Africa
  2. 2.Division of PharmacologyGroote Schuur HospitalCape TownSouth Africa

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