Balkan nephropathy
Jump to navigation
Jump to search
Etiology
- environmental disease?
- long-term consumption of food contaminated with aristolochic acid (a plant alkaloid endemic to the region)?
Epidemiology
- affects only certain endemic rural foci along tributaries of the Danube River in the Balkan countries of Bosnia, Bulgaria, Croatia, Romania, & Serbia (southeastern Europe)
- associated with Chinese herbal medications?[1]
Pathology
- chronic tubulointerstitial kidney disease progressing to end-stage renal disease
- frequent development of upper urinary tract tumors
Clinical manifestations
Laboratory
- glomerular filtration rate decreased
- 24 hour urine protein < 1 g/24 hours
- urinalysis: relatively benign urine sediment
Diagnostic procedures
- cystoscopy as indicated
- cystoscopy with retrogade ureteropyelography[1]
Radiology
Complications
- increased risk of urothelial cancers
More general terms
References
- ↑ Jump up to: 1.0 1.1 1.2 Medical Knowledge Self Assessment Program (MKSAP) 16, 17, 18, 19. American College of Physicians, Philadelphia 2012, 2015, 2018, 2021.
- ↑ Bamias G, Boletis J. Balkan Nephropathy: Evolution of Our Knowledge Am J Kidney Dis. 2008 Sep;52(3):606-16. PMID: https://www.ncbi.nlm.nih.gov/pubmed/18725017
- ↑ Stefanovic V, Polenakovic M Fifty years of research in Balkan endemic nephropathy: where are we now? Nephron Clin Pract. 2009;112(2):c51-6 PMID: https://www.ncbi.nlm.nih.gov/pubmed/19390202
- ↑ Gokmen MR, Cosyns JP, Arlt VM et al The epidemiology, diagnosis, and management of aristolochic acid nephropathy: a narrative review. Ann Intern Med. 2013 Mar 19;158(6):469-77. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/23552405
- ↑ Stefanovic V, Toncheva D, Polenakovic M. Balkan nephropathy. Clin Nephrol. 2015;83(7 Suppl 1):64-9. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/25725245 Free Article
- ↑ Jelakovic B, Dika Z, Arlt VM et al Balkan Endemic Nephropathy and the Causative Role of Aristolochic Acid. Semin Nephrol. 2019 May;39(3):284-296 PMID: https://www.ncbi.nlm.nih.gov/pubmed/31054628
- ↑ Ji H, Hu J, Zhang G, et al. Aristolochic acid nephropathy: a scientometric analysis of literature published from 1971 to 2019. Medicine (Baltimore). 2021;100:e26510. PMID: https://www.ncbi.nlm.nih.gov/pubmed/34232183