Acta Medica Medianae (Apr 2009)
INVESTIGATION OF BALCAN ENDEMIC NEPHROPATHY IN MEMBERS OF ENDEMIC FAMILIES IN THE ENDEMIC VILLAGE MORAVAC
Abstract
The village Moravac, situated on the left bank of the River South Morava, has been known as endemic area for fifty years. The highest prevalence of Balcan Endemic Nephropathy (BEN) was noted during the seventh and eight decade in the last century, and after that period, permanent decreasing has been shown. The present study involved fifty members of endemic families. In all investigated subjects, clinical observations included anamnesis, physical examinations and urinalysis. In twelve (24%) subjects, urinary abnormalities were proven (proteinuria, microhaematuria, leucocyturia). These subjects further underwent the additional functional and morphological examinations at the Clinic of Nephrology, Clinical Center Nis. In 11 (22%) subjects, clinical examinations showed different forms of renal diseases, but BEN was proven in four (one of them suffered from BEN since 2004 and he was treated by haemodialyses, while the others were diagnosed during the investigation). Other renal diseases in the examined patients were: cystic kidney disease (6%), nephrolithiasis (4%), diabetic nephropathy (2%), obstructive nephropathy (4%) and tumores of kidney (2%). In our opinion, based on this investigation, BEN showed the rising tendency. Our retrograde study on the incidence of the upper urinary tract urothelial cancer in the endemic village Moravac showed the highest frequency, like BEN, in the seventh and eight decade in the last century. Despite encouraging results, further detailed and larger investigations are needed along the River South Morava, because a number of studies suggested lower progression and middle clinical course of disease, and also a rare appearance of the upper urinary tract cancer, which is why the patients seldom visit the health institutions, mostly in advanced stage of renal insufficiency. The aim of further investigations is to detect such subjects in the initial, early phase of disease, when prevention of progressive course and therapy are more successful.
