Certain Red Yeast Rice Supplements in Japan Cause Acute Tubulointerstitial Injury

Historically, red yeast rice (Red koji) has been a cornerstone in the culinary and medicinal traditions of East Asia, contributing to the production of alcoholic beverages, fermented foods, and, notably, tofuyo—a fermented tofu delicacy originating from Okinawa, Japan, since the eighteenth century (Supplementary Figure S1, S2). The discovery of monacolin K, a natural statin, within Monascus fungi catalyzed the development of lovastatin, heralding a new era in hyperlipidemia management worldwide.