SP635TRENDS IN INCIDENCE AND PREVALENCE OF PATIENTS WITH ENDEMIC NEPHROPATHY/ ARISTOLOCHIC ACID NEPHROPATHY ON RENAL REPLACEMENT THERAPY IN CROATIA?

Aristolochic acid nephropathy (AAN) is a rapidly progressive renal disease caused by the ingestion of plant products containing aristolochic acid (AA), first described in connection with the use of Chinese herbal medicines. Although the true worldwide extent of this disease is unknown, it is likely to represent a significant cause of chronic kidney disease (CKD) in many parts of the world. Furthermore, recent data have also demonstrated that AA is also the primary aetiological agent in Balkan endemic nephropathy. AAN is notable in its association with urothelial malignancy, with the mechanisms of carcinogenesis now well characterized. Aside from a possible role for corticosteroid therapy in slowing disease progression in selected patients, no disease-specific treatments have yet been shown to alter the course of this nephropathy. Therefore, prevention of exposure to AA and, in affected patients, effective management of the risk of malignancy are key principles in the approach to this condition. Although preparations containing Aristolochia spp. and herbs that can be confused or substituted for Aristolochia have been banned in many countries, other herbal products containing AA have continued to be available to consumers long after these bans have been instituted, highlighting the ongoing need for awareness of this disease.

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Chinese herbs nephropathy and Balkan endemic nephropathy: toward a single entity, aristolochic acid nephropathy

Kidney International ◽

10.1038/ki.2011.428 ◽

2012 ◽

Vol 81 (6) ◽

pp. 513-515 ◽

Cited By ~ 99

Author(s):

Marc E. De Broe

Keyword(s):

Aristolochic Acid ◽

Chinese Herbs ◽

Balkan Endemic Nephropathy ◽

Single Entity ◽

Aristolochic Acid Nephropathy ◽

Endemic Nephropathy ◽

Chinese Herbs Nephropathy

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Is Aristolochic Acid Really the Cause of the Balkan Endemic Nephropathy?

Journal of Controversies in Biomedical Research ◽

10.15586/jcbmr.2016.14 ◽

2016 ◽

Vol 2 (1) ◽

pp. 9-20 ◽

Cited By ~ 4

Author(s):

Peter George Mantle ◽

Diana Herman ◽

Calin Tatu

Keyword(s):

Dna Adducts ◽

Biomedical Research ◽

Human Exposure ◽

Aristolochic Acid ◽

Transitional Cell ◽

Critical Evaluation ◽

Causal Agent ◽

Balkan Endemic Nephropathy ◽

Aristolochic Acid Nephropathy ◽

Endemic Nephropathy

In recent years, aristolochic acid has been promoted vigorously as the causal agent of the Balkan endemic nephropathy because of similarities to some other nephropathies, association with DNA adducts and a perception of human exposure via bread. Critical evaluation of the literature exposes flaws in these aspects, and there has been consistent failure of experimental toxicology to mimic either the slow silent bilateral atrophy of the Balkan disease or the transitional cell carcinomas in the upper urothelium. It seems yet premature to promote the curious Balkan disease as aristolochic acid nephropathy without the epidemiological rigour necessary in biomedical research.

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Trend of Balkan Endemic Nephropathy Patients on Renal Replacement Therapy in Bosnia From 2003 Through 2005

Bosnian Journal of Basic Medical Sciences ◽

10.17305/bjbms.2007.3030 ◽

2007 ◽

Vol 7 (4) ◽

pp. 372-376

Author(s):

Goran Imamović ◽

Enver Zerem ◽

Safet Omerović

Keyword(s):

Diabetes Mellitus ◽

Renal Replacement Therapy ◽

Replacement Therapy ◽

Balkan Endemic Nephropathy ◽

Prevalence Rates ◽

Endemic Region ◽

Population Incidence ◽

Endemic Nephropathy

The aim of this study is to evaluate epidemiological status of Balkan endemic nephropathy (BEN) patients on renal replacement therapy (RRT) in Bosnia from 2003 through 2005. Incidence and prevalence rates of BEN, diabetes mellitus (DM) and RRT population and proportion of BEN RRT population in total RRT population were tracked in renal units covering the entire BEN endemic region in Bosnia. BEN incidence and prevalence rates were 52; 34;48 and 262; 265, 292, respectively. DM incidence and prevalence rates were 7; 13; 8 and 20; 28; 33, respectively. Total RRT population incidence and prevalence rates were 89; 82; 79 and 424; 436; 473, respectively. Proportions of incident BEN RRT population in incident total RRT population and proportions of incident BEN RRT population in incident total RRT population when incident diabetics were subtracted from incident total RRT population were 0,58; 0,41; 0,61, and 0,63; 0,49; 0,67; respectively. Proportions of prevalent BEN RRT population in prevalent total RRT population and proportions of prevalent BEN RRT population in prevalent total RRT population when prevalent diabetics were subtracted from prevalent total RRT population were 0,62; 0,61; 0,62, and 0,65; 0,65; 0,66, respectively. Trend of BEN RRT population was stable in Bosnia from 2003 through 2005.

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