Today Balkan endemic nephropathy is a disease of the elderly with a good prognosis

Bukvić, Danica; Janković, Slavenka; Marić, Ivko; Stošović, Milan; Arsenović, Aleksandra; Djukanović, Ljubica

doi:10.5414/cnp72105

Cited by 9 publications

(8 citation statements)

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“…The majority of BEN patients died from other causes before ESRD appeared. 10 Therefore, a decrease in the incidence of BEN patients on hemodialysis does not necessarily mean that the disease has disappeared. Cukuranovic et al 6 distanced themselves from the statement about BEN disappearance, indicating that urinary abnormalities are more frequent in children from endemic than from non-endemic villages.…”

Section: Discussionmentioning

confidence: 99%

“…The incidence cases were defined as patients with BEN diagnosed according to the criteria proposed by Danilović 9 and published elsewhere. 10 Population estimates were based on 1981, 1991, and 2002 national census data, and, for inter-census years, on the unpublished estimates of the Republic Institute of Statistics, which take into account yearly births and deaths.…”

Section: Methodsmentioning

confidence: 99%

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Trends in Incidence and Prevalence of Balkan Endemic Nephropathy in the Three Most Affected Villages in Serbia Over a 36-Year Period

Janković

Bukvić²,

Marinković

et al. 2013

Renal Failure

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The study was undertaken with the aim to evaluate trends in incidence and prevalence of Balkan endemic nephropathy (BEN) in the villages Šopić, Petka, and Vreoci, Lazarevac municipality, Serbia. Data concerning BEN notifications in the population-based registry of the Special Hospital for Endemic Nephropathy, Lazarevac were used to evaluate BEN incidence rates in the three villages over the period 1973À2008. Population estimates were based on national census data. All age-adjusted incidence rates were standardized to the European standard population and trends were assessed by Poisson regression model and joinpoint analysis. The prevalence of BEN was obtained in cross-sectional studies carried out in the villages Šopić (1971 and 1992), Vreoci (1971and 2002), and Petka (1971 and 2008. The overall agestandardized incidence rates of BEN in the three villages changed over time. The significant 8.6% annual decrease in the first 16 years of the observed period was followed by a slight increase of 4.6% annually in the last two decades. The agestandardized incidence rates changed over time, being the greatest in the years when the field investigations were made. There was an insignificant change in BEN prevalence in Šopić and Vreoci and a significant decrease in prevalence in Petka. During a 36-year period, 367 new cases of BEN were registered in the three endemic villages and the overall agestandardized incidence rate varied over time. As BEN is a slow-progressing and asymptomatic chronic kidney disease, early detection of BEN can only be achieved by field examination.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Trends in Incidence and Prevalence of Balkan Endemic Nephropathy in the Three Most Affected Villages in Serbia Over a 36-Year Period

Janković

Bukvić²,

Marinković

et al. 2013

Renal Failure

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“…Čukuranović i saradnici (11) prikazali su smanjivanje incidencije terminalne insuficijencije bubrega uzrokovane EN u Niškom 3 regionu, što, međutim, ne mora da bude odraz smanjene incidencije bolesti. Bukvić i saradnici (14) pokazali su da je progresija hronične insuficijencije bubrega kod bolesnika sa EN spora, pa mnogi bolesnici ne dožive terminalnu insuficijenciju bubrega nego umiru u ranijim stadijumima bolesti zbog drugih uzroka, najčešće kardiovaskularnih bolesti.…”

Section: Da LI Su Poznate Incidencija I Prevalencija Endemske Nefropaunclassified

Endemic nephropathy: A disease that requires further research

Djukanović¹

2016

Med podmladak

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Endemic nephropathy (EN) is a chronic, tubulointerstitial disease, described 60 years ago in the localized regions of the SouthEast Europe. In spite of numerous studies, the disease still attracts attention of researchers due to a great number of unanswered questions. This study is dedicated to some of those questions. Extensive field research, conducted in all endemic regions, showed the different disease prevalence rates, ranging from 0.3% to 10%. At the beginning of this century, the controversial opinions concerning the disease prevalence occurred, from the assumption that the disease disappears, to the data that the incidence does not change significantly. These differences occur due to a small number of studies conducted over the past thirty years and due to mass migrations from the endemic villages. That is the reason for the lack of exact data on EN prevalence in the endemic regions and for the lack of data on emigrants from endemic regions suffering from EN. EN is a family disease occurring only in the particular foci, thus it is considered that genetic factors, as well as environmental factors, are included in the occurrence of the disease. Currently, there are three hypotheses of EN etiology. One of the oldest assumptions about EN etiology is the one of ochratoxin A, a widely spread mycotoxin. Most of the attention is paid to aristolochic acid as an EN cause, but it is not excluded that, polycyclic aromatic hydrocarbons and other toxic compounds originating from lignite are causes of EN. Thus far, studies have not found out any biomarker which possesses enough specificity and sensitivity to discover and diagnose EN. Therefore, criteria have been defined, consisting of epidemiological, clinical and laboratory parameters which have enabled diagnosis of EN. Over the past decades, various research teams used different diagnostic criteria, thus aggravating results comparison. As a result, a group of experts have recently made a recommendation for screening, diagnosis, classifications and treatment of EN. However, since there is no pathognomonic biomarker for EN, the diagnosis of the disease is established on the basis of proving the presence of defined criteria and excluding other kidney diseases. It indicates that a search for the specific biomarker should be continued. Even after 60 years of endemic nephropathy studies, there are still unanswered questions which require further research by applying contemporary methods.

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“…[11][12][13] Analysis of dialysis centers in the city of Drobeta-Turnu Severin (Romania) shows that about half of the dialyzed patients come from the BEN area, being diagnosed with this disease.…”

Section: Introductionmentioning

confidence: 99%

“…11 If formerly the disease was diagnosed in persons 30-40 years old, rapidly becoming terminal, nowadays it is generally diagnosed at more advanced ages, 40, 50 or even 60 years.…”

Section: Introductionmentioning

confidence: 99%

Familial versus environmental factors in Balkan endemic nephropathy in Mehedinti county, Romania, by means of albuminuria and tubular biomarkers: preliminary study

et al. 2014

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Introduction and aims: Balkan endemic nephropathy (BEN), a regional tubulointerstitial kidney disease encountered in South-Eastern Europe, with still undefined etiology and inexorable evolution towards end stage renal disease, raises the question of the relative contribution of family and environmental factors in its etiology. In order to evaluate the intervention of these factors, markers of tubular injury have been assessed, this lesion being considered an early renal involvement in BEN. Methods: The paper studies relatives of BEN patients currently included in dialysis programmes (for involvement of the family factor) and their neighbors (for involvement of environmental factors) and analyzes them with regard to tubular injury by means of tubular biomarkers (N-acetyl-beta-D-glucosaminidase-NAG and alpha-1-microglobulin), and albuminuria. At the same time, glomerular filtration rate (GFR) (CKD-EPI) was measured. It is considered that, in order to acquire the disease, one should have lived for 20 years in the BEN area. The relatives have been classified according to this criterion. Results: More evident tubular injury was found in the neighbors of BEN patients living for more than 20 years in the endemic area, which argues in favor of environmental factors. Higher levels of urinary alpha-1-microglobulin and albumin in relatives of BEN patients who had been living for more than 20 years in the area than in relatives with a residence under 20 years, plead for the same hypothesis. GFR was lower in persons who had been living for more than 20 years in the BEN area (neighbors and relatives). Conclusions: Environmental factors could be more important in BEN than family factors.

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Today Balkan endemic nephropathy is a disease of the elderly with a good prognosis

Cited by 9 publications

References 0 publications

Trends in Incidence and Prevalence of Balkan Endemic Nephropathy in the Three Most Affected Villages in Serbia Over a 36-Year Period

Trends in Incidence and Prevalence of Balkan Endemic Nephropathy in the Three Most Affected Villages in Serbia Over a 36-Year Period

Endemic nephropathy: A disease that requires further research

Familial versus environmental factors in Balkan endemic nephropathy in Mehedinti county, Romania, by means of albuminuria and tubular biomarkers: preliminary study

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