Balkan nephropathy

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Classification according to ICD-10
N15.0 Balkan nephropathy
ICD-10 online (WHO version 2019)
Balkan nephropathy

The Balkan nephropathy , also Danubian endemic familial nephropathy (DEFN), a form of interstitial nephritis , is a renal disease , chronic and finally extends to a fatal renal insufficiency leads. The high blood pressure, which is usually associated with kidney disease, is initially absent. The disease occurs endemically (exclusively) in some rural regions of the Danube valley and its side valleys in the Balkans, namely in Bosnia, Bulgaria, Croatia, Romania and Serbia.

The cause of the disease, which was first described in the mid-1950s and formally recognized in the ICD in 1956, was unclear for decades despite intensive investigations. Among other things, one suspected mold toxins ( mycotoxins ), herbal medicines used in folk medicine ( phytotoxins ), heavy metals, viruses or a lack of trace elements.

In mid-2007, research by a team from Stony Brook University in the United States was published that uncovered the main cause. The main cause is poisoning from eating bread for several years, the flour of which was ground from wheat from the region contaminated with aristolochic acids . The contamination of the grain comes from the seeds of the common eagle louse ( Aristolochia clematitis , also called beaverweed), a field weed that is not uncommon in this region. The relatively poor farmers in this region have not yet been able to decimate the weeds in the grain fields because they cannot afford expensive herbicides . A serious risk of developing nephropathy exists in around 100,000 people in the affected Balkan region.

The Balkan nephropathy is often accompanied by an otherwise rare cancer of the urothelial tissue of the upper urinary tract . Metabolic products of beaverweed bind to the DNA and trigger mutations there, among other things, in the tumor suppressor protein p53 , so that its function in the human tumor protection system is impaired.

literature

Individual evidence

  1. ↑ AP Grollman et al: Aristolochic acid and the etiology of endemic (Balkan) nephropathy. In: Proc Natl Acad Sci USA . 2007 Jul 17, 104 (29), pp. 12129-12134. Epub 2007 Jul 9, PMID 17620607 .