Kitchen Tox: beware of the durian

November 17, 2015, 10:21 pm




Durian Induced Hyperkalaemia. Leo CLB et al. Med J Malaysia 2011 Mar;66:66-67.

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Durian, a spiky, coconut-sized fruit native to Malaysia and grown throughout southeast Asia, is known for its distinctive aroma that some have compared to ripe Limburger cheese. The Oxford Companion to Food notes that others have compared the smell of durian to “the civet cat, sewage, stale vomit, onions, and cheese; while one disaffected visitor to Indonesia declared that the eating of the flesh was not much different from having to consume used surgical swabs.”

Anthony Bourdain has remarked that after eating durian “Your breath will smell as if you’d been French-kissing your dead grandmother.” Yet many people, especially those from southeast Asia, love durian, and when it’s in season will spend much of their time-consuming fruit after fruit. This can cause problems much worse that halitosis.

In fact, the custardy durian flesh contains even more potassium per 100g than bananas. This is usually not a problem for those with health kidneys, but can cause life-threatening hyperkalemia in people with renal insufficiency. This case report, from Malaysia, describes a 48-year-old woman with diabetes mellitus and end-stage renal failure requiring hemodialysis who suffered a cardiac arrest after eating a “moderate” amount of durian. Her potassium was 9.1 mmol/L and her EKG showed the sine wave pattern typical of hyperkalemia. The patient was resuscitated and ultimately discharged with instructions not to eat durian.

This is not only a problem in southeast Asia. I have a friend whose mother in New York City had renal failure and similarly developed severe hyperkalemia after eating copious amounts of durian.

The following amusing video shows how some children reacted after being exposed to durian:




  1. Phua DH Says:


    It’s a fantastic fruit. Rich in lipid and aroma. Probably have to take quite a fair amount to get hyperkalaemia. Unfortunately the amount normally eaten at one sitting can vary from one seed to multiple fruits shared amongst a few people.

    In Singapore, we love it so much we built a national monument to it, call the Esplanade.

  2. ForensicToxGuy Says:

    A friend describing durian:

    “It’s smells like a thousand fruit bats, onions, garlic, and cantaloupe rotting in a plastic bag in July. Just grim. And it tastes like eating onion-custard out of a dumpster.”

  3. Leon Says:


    I’ve heard it described as being like eating vanilla ice cream in an outhouse. I’ve never had the opportunity to taste fresh Malaysian durian, which is supposed to be the most, um, interesting sample. I’ve had frozen durian, which isn’t overpowering, as well as durian with sticky rice, durian ice cream, and durian smoothies.


    I agree. Hyperkalemia seems to occur from a combination of renal insufficiency and fairly substantial intake of the fruit.