Offspring of parents with Balkan Endemic Nephropathy have higher C-reactive protein levels suggestive of inflammatory processes: a longitudinal study

Abstract

BackgroundDespite the characteristic extensive tubulointerstitial fibrosis, Balkan Endemic Nephropathy (BEN) is usually considered a non-inflammatory disease.MethodsWe examined a marker of inflammation, C-reactive protein (CRP), in the offspring of patients with BEN, a population at risk for BEN, prior to development of established disease to determine if an inflammatory process could be identified in the early stages of the disease. In 2003/04, 102 adult offspring whose parents had BEN and a control group of 99 adult offspring of non-BEN patients were enrolled in this prospective study. This cohort was re-examined yearly for four consecutive years. Levels of serum CRP were measured in years 3 and 4 and compared between groups. The data were analyzed with mixed models.ResultsCompared to controls, offspring of BEN parents had statistically higher CRP levels in two consecutive years, suggestive of early inflammatory reactivity. Whenever the mother was affected by BEN (both parents, or mother only), serum CRP was significantly increased, but not if only the father had BEN. CRP was inversely related to kidney cortex width but not to markers or renal function.ConclusionEarly stages of BEN may involve inflammatory processes. The observation of a maternal involvement supports the concept of fetal programming, which has been implicated in the pathogenesis of other chronic kidney diseases.

The role of a parental history of Balkan endemic nephropathy in the occurrence of BEN: a prospective study

“…However, we found that CRP was associated with parental history, agreeing with a prior study. 17 Since a PHB is an important risk factor for BEN, it is possible that other inflammatory pathways are involved in the development of BEN. Further studies on inflammatory markers are warranted.…”

“…Serum CRP was measured with Immulite (Siemens, Tarrytown, NY) chemiluminescent immunometric assay. 17 …”

“…10,17 Briefly, 104 adult offspring with a PHB were recruited from a hospital database in Vratza, where BEN is still endemic. Ninety-seven adult offspring of non-BEN parents were frequency-matched with regard to sex and 10-year age groups and served as the control group.…”

Survival of patients with upper urinary tract urothelial carcinoma after nephroureterectomy and risk factors for bladder cancer

“…BEN je tubulointersticijska bolest bubrega za koju se smatralo da je ne inflamatornog karaktera [143]. Pojedine studije ukazuju da rani stadijumi BEN mogu biti objašnjeni zapaljenskim procesima [144]. Krajnji stadijum ove bolesti se manifestuje bubrežnom insuficijencijom i smanjivanjen bubrega.…”

“…Krajnji stadijum ove bolesti se manifestuje bubrežnom insuficijencijom i smanjivanjen bubrega. Postoje spekulacije da se antiteta na bubrežno tkivo mogu javiti tokom trudnoće i da na taj način naprave promene na bubrezima ploda [144]. Sadašnja hipoteza se zasniva na uticaju aristolohične kiseline (detaljni podaci u uvodu), mada virusna etiologija, geohemijski i genetski faktori ne mogu biti zanemareni [145].…”