[Epidemiologic characteristics of endemic nephropathy in Croatia in 2005]

Endemic nephropathy (EN) is chronic renal disease of unknown etiology, characterized with ominous onset and progressive clinical course. It occurs in rural areas in values of tributaries of the river Danube. According to the census from 2001, 10865 farmers live in Croatian endemic focus, i. e. 14 villages in Brod Posavina County. Apart from kidney impairment, high incidence of urothelial cancers is a hallmark of EN. Due to this, most agents that have been investigated were nephrotoxic and carcinogen.

In the last 25 years approximately 70% of 13 Croatian endemic villages' inhabitants were examined following WHO criteria. In spring 2005, 1081 inhabitants of 3 endemic villages (Kaniza, Bebrina, Banovci) and control village of Klakar were examined using the same criteria, and persons were divided as follows: diseased of EN, suspect of having EN, at risk for EN and others.

In the group of 1081 persons, we found 25 diseased of EN (12 men and 13 women): Bebrina 11, Banovci 9, Kaniza 5 (chi2 = 8.06; p < 0.05). Prevalence of EN in Kaniza was 0.6%, Bebrina 2.1% and Banovci 2.3%, while prevalence of suspect of EN was 1.7%, 6%, 6%, respectively. One fifth of inhabitants were at risk of having EN.

This epidemiologic survey that was conducted in spring 2005 found out that prevalence of EN in Croatia is approximately the same as it was in the last decades. Apart from renal impairment, high incidence of urothelial cancers is characteristic of EN in this region. In addition to medical and scientific, we will need social and political help in elucidating the etiology of EN as well as in improving treatment and cure of this poor rural population.