Something fishy: Raw fish bile-induced acute kidney injury

Acute kidney injury (AKI) can be caused by a number of etiologies. A rare but potentially life-threatening cause is the consumption of raw fish. This practice is rampant in certain parts of India as well as Asia due to the traditional belief that it can cure a number of chronic diseases such as bronchial asthma, arthritis and diabetes mellitus. A toxin present in fish gallbladder can cause multiorgan failure. Renal involvement is generally in the form of oliguric AKI and in majority of the cases requires renal replacement therapy. Early institution of supportive therapy is essential to prevent mortality. We report the case of a middle-aged diabetic female who consumed raw fish gallbladder in the hope of curing her diabetes and landed up with renal dysfunction requiring dialysis. Renal biopsy showed acute interstitial nephritis which was treated with steroids. She made a full recovery on follow-up.