Renal function, protein excretion and pathology of Balkan endemic nephropathy. I. Renal function

Area of Science:

• Nephrology
• Endocrinology
• Public Health

Background:

• Balkan endemic nephropathy (BEN) is a unique tubulointerstitial disease with geographic and familial clustering.
• Clinical presentation and early diagnostic markers for BEN remain poorly defined.

Purpose of the Study:

• To investigate renal function and clinical characteristics in patients with Balkan endemic nephropathy (BEN).
• To identify potential early diagnostic indicators for BEN.

Main Methods:

• Renal function was assessed using DTPA clearance in 59 patients diagnosed with BEN.
• Patients were stratified into three groups based on DTPA clearance levels.
• Clinical symptoms, anemia, proteinuria, concentrating ability, and kidney size (ultrasound) were evaluated.

Main Results:

• No specific or characteristic symptoms distinguished the three groups.
• Anemia was not an early indicator. Proteinuria was minimal and intermittent across all groups.
• Reduced maximum concentrating ability was observed only in the lowest clearance group; decreased kidney size was noted in all groups.

Conclusions:

• Clinical features and standard renal function tests do not reliably differentiate BEN from other chronic tubulointerstitial nephropathies.
• Geographic isolation, familial occurrence, and minimal proteinuria characterize BEN.
• Decreased kidney size on ultrasound may represent an early, characteristic feature of BEN.