While toxic mushroom ingestions are generally known for their ability to cause acute liver failure, certain varieties of mushrooms can also result in acute renal failure. One such type of mushroom is Amanita smithiana, (shown at left) which is responsible for causing relatively rapid (e.g. within a few days of ingestion) renal failure. The mechanism is felt to be ATN and there have been several case reports of this type of mushroom ingestion in the Pacific Northwest region of the United States.
Another distinct type of mushroom-induced acute renal failure is those produced by Cortinarius species (shown at bottom). These are found mostly in Europe, and the mechanism of renal injury here is a tubulointerstitial nephritis. As such, onset can be delayed (3 days - 3 weeks) and often less severe than Amanita-induced renal toxicity.
Also, as liver failure is still the most common disease associated with toxic mushroom ingestion, hepatorenal syndrome (as a secondary event) must also need to be strongly considered in an individual with renal failure following mushroom ingestion.
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