Groundwater chemistry and the Balkan endemic nephropathy

Until now failure has been a common feature of all attempts to elucidate the aetiology of Balkan endemic nephropathy (BEN), a peculiar kidney disease known to exist only in south-eastern Europe. However, whatever the cause, many epidemiological data point to water as a vehicle of the unknown agent(s). We addressed the issue by reexamining multielement hydrogeochemical data obtained by one of us (WME) in the field, as well as other relevant pieces of evidence.Well water samples were obtained from 18 households heavily affected by BEN, and situated in nine villages scattered over six distinct endemic areas. Control samples were taken from non-affected households exposed to the BEN environment (2), as well as from neighbouring non-endemic villages (5).In terms of the chemical composition of well water, considerable differences between the areas were observed. As a rule the water chemistry of BEN-affected households was rather similar to control samples but there were large variations within each of the two groups.Though none of the wide range of geochemical and hydrogeological parameters have been positively implicated as related to BEN, water-borne chemicals still remain a clue to be pursued, particularly in relation to ultratrace concentrations of bioessential elements and organics.