Comments

It is not known if the consumption of Aloe Vera hand lotion triggered the renal insufficiency in this patient, or simply exacerbated an already existing condition. In any event, the case demonstrates several important points related to folk medical beliefs and practices.

1. Although originally from Mexico, this patient was reasonably well acculturated into the American way of life, but decided to see a curandero (lay healer) anyway.
2. People with chronic illnesses are easily discouraged and will seek answers outside the medical profession if they feel that the physician is not providing effective treatment.
3. The importance of taking a complete history cannot be underestimated. While intake of pure aloe vera has not been associated with kidney damage, her worsening renal insufficiency may well be due to factors including the propylene glycol and chronic dehydration from purging.
4. Patients may not know what substance they are actually taking when they are given or purchase folk remedies; there is no "quality control" or mechanism to achieve appropriate dosing.
5. Because herbal remedies are considered to be "natural" (in contrast to the chemicals used by the medical profession), they are felt to be safe and effective.