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PMID: 9799184 Published · ppublish English Journal Article Research Support, Non-U.S. Gov't Review

The etiology of Balkan endemic nephropathy: still more questions than answers.

Environmental health perspectives ·Vol. 106 ·No. 11 ·1998-11-00 ·Pages 689-700

Tatu CA, Orem WH, Finkelman RB, Feder GL

Abstract

Balkan endemic nephropathy (BEN) has attracted increasing attention as a possible environmental disease, and a significant amount of research from complementary scientific fields has been dedicated to its etiology. There are two actual competing theories attempting to explain the cause of this kidney disease: 1) the mycotoxin hypothesis, which considers that BEN is produced by ochratoxin A ingested intermittently in small amounts by the individuals in the endemic regions, and 2) the Pliocene lignite hypothesis, which proposes that the disease is caused by long-term exposure to polycyclic aromatic hydrocarbons and other toxic organic compounds leaching into the well drinking water from low rank coals underlying or proximal to the endemic settlements. We outline the current developments and future prospects in the study of BEN and differentiate possible factors and cofactors in disease etiology.

MeSH Terms
Balkan Nephropathy/complications,epidemiology,etiology Carcinogens/adverse effects Environmental Exposure/adverse effects Europe, Eastern/epidemiology Humans Mycotoxins/adverse effects Ochratoxins/adverse effects Risk Factors Urologic Neoplasms/etiology p-Aminohippuric Acid/adverse effects
Chemicals
Carcinogens Mycotoxins Ochratoxins ochratoxin A p-Aminohippuric Acid
Authors & Affiliations
4 authors, click to expand affiliations / ORCID
Tatu C A
Forslys Group, Timisoara, Romania.
Orem W H
Finkelman R B
Feder G L
References (43)
43 references, click to expand
  1. Chemical qualities of water that contribute to human health in a positive way.
    Sci Total Environ. 1986 Oct;54:207-16 PMID: 3810127
  2. Selenium deficiency in Serbia and possible effects on health.
    Biomed Environ Sci. 1997 Sep;10(2-3):300-6 PMID: 9315323
  3. The toxicology of mycotoxins.
    Crit Rev Toxicol. 1985;14(2):99-132 PMID: 3158480
  4. Interaction between dose and susceptibility to environmental cancer: a short review.
    Environ Health Perspect. 1997 Jun;105 Suppl 4:749-54 PMID: 9255556
  5. Polymorphisms in drug-metabolizing enzymes: what is their clinical relevance and why do they exist?
    Am J Hum Genet. 1997 Feb;60(2):265-71 PMID: 9012398
  6. Urinary tract tumors and Balkan nephropathy in the South Morava River basin.
    Kidney Int Suppl. 1991 Nov;34:S80-4 PMID: 1762341
  7. [Chronic nephritis due to lead poisoning by digestive route (flour)].
    Presse Med. 1957 Dec 11;65(90):2039-40 PMID: 13505667
  8. Further data on the prevalence of serum antibodies to papova viruses (BK and SV40) in subjects from the Romanian area with Balkan endemic nephropathy.
    Virologie. 1984 Jan-Mar;35(1):65-7 PMID: 6324450
  9. Molecular and epidemiological approaches to the etiology of urinary tract tumors in an area with Balkan endemic nephropathy.
    J Environ Pathol Toxicol Oncol. 1996;15(2-4):201-7 PMID: 9216807
  10. Foodstuffs and human blood contamination by the mycotoxin ochratoxin A: correlation with chronic interstitial nephropathy in Tunisia.
    Arch Toxicol. 1995;69(8):552-8 PMID: 8534199
  11. Clinical features of Balkan endemic nephropathy.
    Food Chem Toxicol. 1992 Mar;30(3):189-92 PMID: 1618441
  12. Chronic interstitial nephritis as a cause of tumours of the upper urinary tract. A hypothesis.
    Urol Int. 1979;34(6):393-402 PMID: 494441
  13. Epidemiology of Balkan endemic nephropathy.
    Food Chem Toxicol. 1992 Mar;30(3):183-8 PMID: 1618440
  14. Epidemiological evidence on Balkan nephropathy as a viral disease.
    Med Hypotheses. 1987 Feb;22(2):171-5 PMID: 3646457
  15. Serum antibodies to papova viruses (BK and SV 40) in subjects from the area with Balkan endemic nephropathy.
    Virologie. 1983 Apr-Jun;34(2):113-7 PMID: 6308885
  16. Balkan endemic nephropathy, the haematopoietic system and the environmental connection.
    Food Chem Toxicol. 1998 Mar;36(3):245-7 PMID: 9609397
  17. Ochratoxin A in human blood in relation to nephropathy in Tunisia.
    Hum Exp Toxicol. 1995 Jul;14(7):609-14 PMID: 7576823
  18. Evidence of a viral aetiology in endemic (Balkan) nephropathy.
    Lancet. 1975 Dec 27;2(7948):1271-3 PMID: 54796
  19. [Traditional remedy-induced Chinese herbs nephropathy showing rapid deterioration of renal function].
    Nihon Jinzo Gakkai Shi. 1997 Dec;39(8):794-7 PMID: 9483946
  20. [Renal changes in rats and mice caused by total extracts of water and residue obtained from a herd with endemic nephropathy].
    Arch Roum Pathol Exp Microbiol. 1980 Jan-Mar;39(1):63-8 PMID: 7406679
  21. Balkan nephropathy. Kidney disease beyond the Balkans?
    Am J Nephrol. 1991;11(1):1-11 PMID: 2048572
  22. Understanding gene-environment interactions.
    Environ Health Perspect. 1997 Jun;105(6):578-80 PMID: 9288489
  23. Cytokine levels in patients with Balkan nephropathy.
    Nephron. 1993;63(4):483 PMID: 8459894
  24. Identification of a novel subset of T lymphocytes in patients with Balkanic nephropathy.
    Autoimmunity. 1996;23(2):119-26 PMID: 8871767
  25. Possible pathogenetic role of low-molecular-weight proteins in Balkan nephropathy.
    Kidney Int Suppl. 1991 Nov;34:S89-92 PMID: 1762343
  26. Selenium. Mechanistic aspects of anticarcinogenic action.
    Biol Trace Elem Res. 1992 Apr-Jun;33:51-62 PMID: 1379460
  27. Letter: Viruses in endemic (Balkan) nephropathy.
    Lancet. 1976 May 15;1(7968):1086 PMID: 57502
  28. Selenium deficiency in Yugoslavia.
    Biol Trace Elem Res. 1992 Apr-Jun;33:187-96 PMID: 1379455
  29. Eastern Europe: missing an opportunity.
    Science. 1990 Apr 6;248(4951):20-2 PMID: 2321022
  30. On Danubian endemic familial nephropathy (Balkan nephropathy). Some problems.
    Am J Med. 1970 Dec;49(6):774-9 PMID: 5006615
  31. Genetic predisposition to Balkan endemic nephropathy.
    Nephron. 1996;72(4):564-9 PMID: 8730422
  32. Environmental renal disease: lead, cadmium and Balkan endemic nephropathy.
    Kidney Int Suppl. 1991 Nov;34:S4-8 PMID: 1762331
  33. Some features of Balkan endemic nephropathy.
    Food Chem Toxicol. 1992 Mar;30(3):177-81 PMID: 1618439
  34. The role of individual susceptibility in cancer burden related to environmental exposure.
    Environ Health Perspect. 1996 May;104 Suppl 3:569-77 PMID: 8781385
  35. Endemic nephropathy in Yugoslavia.
    Arch Pathol. 1972 Apr;93(4):372-4 PMID: 5017288
  36. Is ochratoxin a nephrotoxic in human beings?
    Adv Nephrol Necker Hosp. 1997;26:181-206 PMID: 8922134
  37. Balkan endemic nephropathy: more questions than answers.
    Nephron. 1992;62(1):1-5 PMID: 1436271
  38. Ochratoxin A in human sera in the area with endemic nephropathy in Croatia.
    Toxicol Lett. 1997 Apr 28;91(2):105-9 PMID: 9175846
  39. Cytogenetic studies in Balkan endemic nephropathy.
    Nephron. 1988;48(1):18-21 PMID: 3422361
  40. Role of ochratoxin in disease causation.
    Food Chem Toxicol. 1992 Mar;30(3):213-24 PMID: 1618445
  41. Balkan nephropathy.
    Practitioner. 1981 Jul;225(1357):1031-8 PMID: 7312768
  42. Relationship between weathered coal deposits and the etiology of Balkan endemic nephropathy.
    Kidney Int Suppl. 1991 Nov;34:S9-11 PMID: 1762344
  43. Chinese herbs nephropathy: a clue to Balkan endemic nephropathy?
    Kidney Int. 1994 Jun;45(6):1680-8 PMID: 7933816
Article Info
Journal
Environmental health perspectives
Abbr.
Environ Health Perspect
ISSN
0091-6765
DOI
10.1289/ehp.106-1533478
Published
1998-11-00
Pages
689-700
Language
English
Region
United States
NLM ID
0330411
PMCID
PMC1533478
Subset
IM
External Links
PubMed source DOI: 10.1289/ehp.106-1533478 PMC Full Text View journal details
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