Heavy juicing of oxalate-rich greens (about 1,500 mg oxalate per day) can cause acute oxalate nephropathy, especially in people with chronic kidney disease.
Original statement
No Arabic original wording available.
Translation
Heavy juicing of oxalate-rich greens (about 1,500 mg oxalate per day) can cause acute oxalate nephropathy, especially in people with chronic kidney disease.
Origin
- Source status
- Archive editors
- Attribution
- Archive editors
- Origin
- https://eltayebat.com/rule/leafy-greens-cucurbits/
- Attribution uncertainty
- Archive editorial text and study selection written by the archive operators, not necessarily by Elawady.
- Claimed mechanism
Massive oxalate load precipitates calcium oxalate in kidney tissue.
- Claimed health effect
Acute renal failure.
- Population concerned
People with CKD who consume large amounts of oxalate-rich juice
- Geographic restriction by Elawady
none found
Scientific assessment
Mostly true – Correct at its core, but with limitations or minor inaccuracies.
Certainty of evidence: low – Further research is likely to change the assessment considerably.
1. What was claimed?
Excessive green juicing can damage the kidneys.
2. What is demonstrably correct?
Correct as a rare event: the abstract describes oxalate-induced acute renal failure from juicing and warns that oxalate-rich diets may precipitate renal failure in CKD.
3. What is wrong or exaggerated?
This concerns extreme intakes in concentrated juice form, not normal portions of cooked or raw greens.
4. What remains unclear?
The frequency of such events is unknown.
5. Which studies support it?
Getting 2013.
6. Which studies contradict it?
None.
7. What applies to Germany and Europe?
Relevant to juice cleanses marketed in Europe.
8. What is known about Egypt?
Not specific.
9. What practical conclusion is appropriate?
People with kidney disease should avoid high-dose green juices; normal vegetable intake is a different situation.
Assessment details
- Rationale for certainty of evidence
Supported by case reports and a Mayo Clinic case series (3 of 65 biopsy cases with presumed diet-induced oxalate nephropathy, all with CKD). Case data cannot quantify risk; the 1,500 mg figure is from the archive card and was not verified in the abstract.
- Source quality
Case report and review; archive summary broadly correct.
- Regional transferability
Applies everywhere; juicing trends exist in Germany.
- Individual exceptions
Primarily people with CKD; relevant for juice 'detox' regimens.
- Regional scope of the claim
- not specified
- Last reviewed
- 26 October 2026 provisional
Scientific evidence in detail
True only under certain conditions – The claim holds only for certain doses, groups of people, preparations or circumstances.
Research question: Can heavy juicing of oxalate-rich greens cause acute oxalate nephropathy, particularly in people with CKD or other risk factors?
Research question in detail (PECO)
- Population
- Adults, especially with CKD, gastric bypass, malabsorption
- Intervention or exposure
- Concentrated green juices / smoothies
- Comparison
- Normal intake
- Geographic scope
- universal biology
- Outcomes
- acute kidney injury
- dialysis
Study results as reported by the authors. Our assessment follows below.
What speaks for the claim?
Oxalate kidney damage is rare but severe
Lumlertgul N et al.. Kidney Int Rep 2018 · PMID 30450463 · DOI 10.1016/j.ekir.2018.07.020 Systematic reviewabstract checkednewly addedSystematic review of 108 secondary oxalate nephropathy cases.
- Actual result
- Dietary oxalate attributed in 20%; 55% required dialysis; 58% dialysis-dependent; 33% died.
- Methodological quality
- low (case reports)
- Relevance
- direct
- Limitations
- No denominator; publication bias.
Mayo Clinic: diet behind some oxalate kidney damage
Reddy S et al.. Am J Nephrol 2021 · PMID 34844241 · DOI 10.1159/000520286 Case series / case reportabstract checkednewly addedMayo Clinic biopsy cohort.
- Actual result
- Dietary oxalate 7 of 64 non-primary cases; 40.6% dialysis.
- Methodological quality
- low
- Relevance
- direct
- Limitations
- Selected.
Kidney damage from green juicing
Getting JE et al.. Am J Med 2013 · PMID 23830537 · DOI 10.1016/j.amjmed.2013.03.019 Case series / case reportabstract checkedGetting 2013 juicing case report and review.
- Actual result
- Oxalate nephropathy after juicing in CKD.
- Methodological quality
- very low
- Relevance
- direct
- Limitations
- Case.
What speaks against the claim?
No high-quality evidence against the claim was found.
What does the overall evidence say?
Editorial assessment based on the studies above – not itself a study result.
Which position is better supported?
A real but rare risk, almost always with predisposing factors (CKD, bariatric surgery, malabsorption, antibiotics, dehydration).
Why some studies weigh more
Only case-level evidence exists, but it is consistent and biologically plausible.
Is a causal relationship established? Probable Temporal association, biopsy confirmation, plausible dose (very high soluble oxalate in raw juice).
Remaining uncertainty
Incidence; the archive's 1,500 mg/day figure remains unverified.
Justified conclusion
Mostly true as a rare, conditional risk.
Does this depend on the country?
- General biological effects
- Universal biology.
- Eating habits
- not applicable
- Origin of the food
- not applicable
- Contaminants
- not applicable
- National production conditions
- not applicable
- Legal rules
- not applicable
- Actual monitoring data
- not applicable
A regional difference that changes the conclusion is not supported by robust data.
Statistical re-check
- Number of diet-attributed cases – ~22 of 108. recalculated
- Proportion diet-attributed – 7/64 = 11%. recalculated
Certainty of the overall evidence (GRADE, simplified)
- Main outcome
- Acute oxalate nephropathy after juicing
- Starting level
- low (observational studies)
- Reasons for downgrading
- risk of bias (case reports)
- Result
- low
Simplified assessment by a single reviewer, following the GRADE approach; not a formal GRADE panel. GRADE rates the body of evidence for one outcome, not individual studies.
Search strategy
Documented literature searches for this review (search strings in the original database syntax).
| Database | Date | Search | Looking for | Hits | Included |
|---|---|---|---|---|---|
| PubMed | 26 October 2026 | (oxalate) AND (boiling OR cooking OR steaming) AND (vegetable* OR spinach) AND (soluble oxalate) | both directions | 8 | |
| PubMed | 26 October 2026 | ("oxalate nephropathy") AND (juic* OR "green smoothie" OR spinach OR "dietary oxalate") | supporting evidence | 30 |
Open questions
The archive's 1,500 mg/day figure: not found in abstracts read.
How deeply was this checked?
5 linked studies: 0 checked in full text (0 of them with a structured risk-of-bias assessment), 5 on the basis of the abstract, 0 bibliographically only. No formal assessment with two independent reviewers and no independent human expert review has taken place yet.
Last scientific review: 26 October 2026
History of the verdict
- 25 October 2026 · Phase 1 · Initial assessment: Mostly true (low)
- 26 October 2026 · Phase 4 (systematic evidence review) · Re-examined with extended evidence; verdict unchanged: Mostly true (low)
Systematic review and biopsy series confirm a rare conditional risk; raw vs cooked oxalate data explain why juices differ from cooked greens.
New sources: I-VEG-119 I-VEG-120 I-VEG-121 I-VEG-122
In plain language
Drinking very large amounts of juice made from spinach and similar greens can, in rare cases, damage the kidneys, mainly in people who already have kidney disease. This has been documented in case reports. It applies to extreme juicing, not to ordinary servings of vegetables.
Studies on this claim
Studies supporting the claim (4)
-
Kidney damage from green juicing
Getting JE et al.. Am J Med 2013 · PMID 23830537 · DOI 10.1016/j.amjmed.2013.03.019Case series / case reportcited by the Tayebat archiveabstract checked★ key studyRare kidney failure from heavy oxalate-rich juicing, mainly in people with kidney disease.
Does the study support the specific claim? Partly · Methodological quality: low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Describe juicing nephropathy
- How was the study done?
Case report + series
- How many people, animals or samples were studied?
65 reviewed patients plus index case report
- What was actually found?
Diet cause in 3 with CKD
- How large was the observed effect?
Not applicable
- What do the results mean in everyday life?
Kidney patients should avoid juice cleanses.
- What are the study's limitations?
Case data
- What does it say about Elawady's specific claim?
Supports niche risk
- Do the results apply to Germany and Europe?
High
- What can explicitly not be concluded from this study?
Cannot show risk of normal vegetable intake.
-
Oxalate kidney damage is rare but severe
Lumlertgul N et al.. Kidney Int Rep 2018 · PMID 30450463 · DOI 10.1016/j.ekir.2018.07.020Systematic reviewindependent cross-checkabstract checked★ key studyAmong 108 published cases of secondary oxalate nephropathy, excessive dietary oxalate was a cause in about 1 in 5; over half needed dialysis.
Dietary oxalate attributed in 20% of 108 secondary oxalate nephropathy cases; outcomes severe.
Does the study support the specific claim? Yes · Methodological quality: low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Describe secondary oxalate nephropathy.
- How was the study done?
Systematic review of case reports.
- How many people, animals or samples were studied?
108 patients.
- What was actually found?
Rare, severe; diet one of several causes.
- How large was the observed effect?
55% dialysis; 33% died.
- What do the results mean in everyday life?
Extreme oxalate intake can harm kidneys, especially in people with other risks.
- What are the study's limitations?
Case reports only.
- What does it say about Elawady's specific claim?
Supports the juicing-risk claim.
- Do the results apply to Germany and Europe?
Universal.
- What can explicitly not be concluded from this study?
Cannot estimate risk per person.
-
Mayo Clinic: diet behind some oxalate kidney damage
Reddy S et al.. Am J Nephrol 2021 · PMID 34844241 · DOI 10.1159/000520286Case series / case reportindependent cross-checkabstract checkedOf 64 biopsy cases, 7 were attributed to dietary oxalate; outcomes were often poor.
Dietary oxalate in 7 of 64 non-primary ON cases at Mayo Clinic.
Does the study support the specific claim? Yes · Methodological quality: low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Characterise non-primary oxalate nephropathy.
- How was the study done?
Retrospective biopsy cohort.
- How many people, animals or samples were studied?
64 patients.
- What was actually found?
Diet one cause among several; severe outcomes.
- How large was the observed effect?
7/64 dietary.
- What do the results mean in everyday life?
Extreme oxalate diets can damage kidneys, but this is rare.
- What are the study's limitations?
Selected cases.
- What does it say about Elawady's specific claim?
Supports conditional claim.
- Do the results apply to Germany and Europe?
Universal.
- What can explicitly not be concluded from this study?
Cannot estimate risk for juicers.
-
Green smoothie cleanse led to kidney failure
Makkapati S et al.. Am J Kidney Dis 2018 · PMID 29203127 · DOI 10.1053/j.ajkd.2017.08.002Case series / case reportindependent cross-checkabstract checkedA 65-year-old woman with earlier gastric bypass developed permanent kidney failure after a green juice cleanse.
Green smoothie cleanse with ESRD in a predisposed patient.
Does the study support the specific claim? Yes · Methodological quality: very low · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Report a case.
- How was the study done?
Case report.
- How many people, animals or samples were studied?
1 patient.
- What was actually found?
Oxalate nephropathy to ESRD.
- How large was the observed effect?
Not applicable.
- What do the results mean in everyday life?
Juice cleanses can be dangerous for people with bowel surgery or kidney disease.
- What are the study's limitations?
Single case.
- What does it say about Elawady's specific claim?
Supports conditional claim.
- Do the results apply to Germany and Europe?
Universal.
- What can explicitly not be concluded from this study?
Cannot generalise to normal vegetable intake.
No study in this group is marked as key.
Studies contradicting or limiting the claim (0)
No studies in this group.
Studies with mixed or unclear results (1)
-
Boiling greens removes much of their oxalate
Chai W et al.. J Agric Food Chem 2005 · PMID 15826055 · DOI 10.1021/jf048128dMeasurement / residue studyindependent cross-checkabstract checkedBoiling cut soluble oxalate by 30-87% in nine vegetables; steaming removed less.
Raw juicing preserves soluble oxalate; cooking reduces it.
Does the study support the specific claim? Partly · Methodological quality: moderate · Certainty of evidence: see overall assessment of the claim
Original publication · Scientific details
Study explained simply
- What did the researchers want to find out?
Measure oxalate loss with cooking.
- How was the study done?
Food analysis.
- How many people, animals or samples were studied?
9 vegetables.
- What was actually found?
Boiling most effective.
- How large was the observed effect?
30-87% reduction.
- What do the results mean in everyday life?
Boiled greens (water discarded) contain far less soluble oxalate than raw juice.
- What are the study's limitations?
No human outcomes.
- What does it say about Elawady's specific claim?
Limits the generalisation; supports the juicing-specific risk.
- Do the results apply to Germany and Europe?
Universal.
- What can explicitly not be concluded from this study?
Cannot show stone risk directly.
No study in this group is marked as key.
Regional context
Germany / EU
Relevant to juice cleanses marketed in Europe.
Egypt
Not specific.
What applies in my country?
General scientific assessment
Mostly true A real but rare risk of extreme juicing, mainly in kidney patients.
The following areas of food safety are relevant to this statement:
- Pesticides and pesticide residues
- Contaminants (heavy metals, PFAS, PCBs, dioxins, nitrate)
- Pathogens (Salmonella, Campylobacter, etc.)
Fruit and vegetables
Choose a country to see the checked information for it.
Limits: legal rules describe what is allowed, not what every single food contains. Measurement data come from samples and are meaningful only together with their method details.
Country of residence or purchase Compare with another country
References
- Oxalate nephropathy due to 'juicing': case report and review.. Getting JE et al.. Am J Med 2013 · PMID 23830537 · DOI 10.1016/j.amjmed.2013.03.019
- Secondary Oxalate Nephropathy: A Systematic Review.. Lumlertgul N et al.. Kidney Int Rep 2018 · PMID 30450463 · DOI 10.1016/j.ekir.2018.07.020
- Clinical Outcomes and Histological Patterns in Oxalate Nephropathy due to Enteric and Nonenteric Risk Factors.. Reddy S et al.. Am J Nephrol 2021 · PMID 34844241 · DOI 10.1159/000520286
- "Green Smoothie Cleanse" Causing Acute Oxalate Nephropathy.. Makkapati S et al.. Am J Kidney Dis 2018 · PMID 29203127 · DOI 10.1053/j.ajkd.2017.08.002
- Effect of different cooking methods on vegetable oxalate content.. Chai W et al.. J Agric Food Chem 2005 · PMID 15826055 · DOI 10.1021/jf048128d