Seta Devi, 48, a resident of Ranchi was admitted in Sir Ganga Ram Hospital with vomiting and severe kidney injury. On questioning, it was revealed that she consumed the raw gallbladder of a locally available “rohu” (Labeo rohita) for 3 days to cure her diabetes as advised by a local quack. After a few days, she developed severe nausea and vomiting. With her worsening condition, her family brought her to Sir Ganga Ram Hospital. She was admitted in Department of Nephrology, where she underwent 2 sessions of hemodialysis. Her kidney biopsy revealed severe inflammation. She was started on high dose steroids with supportive treatment. By 7th day, her kidney function started to recover and after 2 weeks, she was discharged with normal kidney function.

Raw fish gall bladder consumption is a common practice in certain regions of Asia including India, particularly eastern and southern India. It is traditionally believed to cure diabetes mellitus, bronchial asthma, arthritis and visual disturbances amongst others.

The most commonly implicated fish species are the Rohu (Labeo rohita) and the Catla (Catla catla), which are both commonly consumed in many parts of the country.

According to Dr. (Prof.) A.K. Bhalla, Chairman, Department of Nephrology, Sir Ganga Ram Hospital, “It is important to note that the risk of kidney injury is not limited to these two species of fish and can also occur with the consumption of gallbladder from other types of fish. Therefore, I recommend to avoid the consumption of raw fish gallbladder altogether to prevent potential health risks. These fish naturally produce high levels of bile in their digestive systems, which can be harmful to humans when ingested in large quantities”.

The bile contains a toxin called cyprinol, which has been shown to cause kidney damage in humans. Symptoms of fish bile-associated kidney injury can include abdominal pain, vomiting, and decreased urine output. In severe cases, the condition can lead to kidney failure and even death.

According to Dr. Vaibhav Tiwari, Consultant, Department of Nephrology, Sir Ganga Ram Hospital, “To prevent fish bile-associated kidney injury, we recommend avoiding consuming fish that are known to have high levels of bile. It is also important to ensure that fish is properly prepared and cooked thoroughly, as this can help to reduce the levels of toxins present in the fish.

In addition to these precautions, individuals who experience symptoms of fish bile-associated kidney injury should seek medical attention immediately. Treatment may involve supportive care, such as hydration and pain management, as well as measures to protect the kidneys from further damage. In this particular case, timely diagnosis and initiation of appropriate therapy ensured optimal outcome”.