Djenkolism is an uncommon but important cause of
acute kidney injury. It sporadically occurs after an ingestion of the djenkol bean (Archidendron pauciflorum), which is native to Southeast Asia. The clinical features defining djenkolism include: spasmodic suprapubic and/or
flank pain; urinary obstruction; and
acute kidney injury. The precise pathogenesis of
acute kidney injury following djenkol ingestion remains unknown. However, it is proposed that an interaction between the characteristics of the ingested beans and the host factors causes hypersaturation of
djenkolic acid crystals within the urinary system, resulting in subsequent obstructive nephropathy with sludge, stones, or possible
spasms. We report a case of djenkolism from our rural clinic in Borneo, Indonesia. Our systematic literature review identified 96 reported cases of djenkolism. The majority of patients recovered with hydration,
bicarbonate therapy, and
pain medication. Three patients required surgical intervention; one patient required ureteral stenting for the obstructing
djenkolic acid stones. Four of the 96 reported patients died from
acute kidney failure. We stress the importance of awareness of djenkolism to guide medical practitioners in the treatment of this
rare disease in resource-poor areas in Southeast Asia.