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Human ochratoxicosis and nephropathy in Egypt: a preliminary study
E W Wafa1, R S Yahya, M A Sobh
1Laboratoire de Toxicologie et Hygiène Appliquée, Faculté des Sciences Pharmaceutiques, Université Victor Segalen Bordeaux 2, France.
Abstract:
This preliminary study was designed in a trial to delineate the size of the problem of ochratoxicosis and its relation to genesis of lesions mounting to end stage renal disease (ESRD) or urothelial tumors in Egypt. This study comprised five groups of patients having renal diseases of different presentations; they are: patients with (ESRD) under conservative medical treatment (group 1), patients with (ESRD) under treatment with regular hemodialysis (group 2), renal allograft recipients (group 3), patients with nephrotic syndrome (group 4) and patients with urothelial tumors (group 5). In addition, two reference groups: potential related donors for renal transplantation (group 6) and healthy control with negative family history of renal disease (group 7). For all groups, laboratory, radiological and histopathological evaluation of kidney status were carried out coupled with determination of ochratoxin A level in serum, in urine and in biopsy specimens of patients with urothelial tumors. High ochratoxin serum levels were found in patients with ESRD (groups 1 and 2) (P < 0.01), higher serum levels were detected in the group without dialysis (group 1) in comparison with the reference groups possibly due to ochratoxin. A clearance by dialysis. Ochratoxin A was detected in serum and urine of renal transplant recipients (group 3) (P < 0.01) and especially higher levels were found in patients with nephrotic syndrome (group 4) (P < 0.001). For the group with urothelial tumor (group 5), positive serum, urine and tissue biopsy specimens for ochratoxin levels were found (P < 0.01). The results could lead to the conclusion that ochratoxin A could be correlated to the genesis of renal disease leading to (ESRD) or causing urothelial cancer. A thorough and in depth study of the problem of ochratoxicosis and renal disease causation in Egypt is now recommended.
Insights
This study suggests ochratoxin A may be linked to kidney disease and urothelial tumors in Egypt. Higher levels were found in patients with end-stage renal disease (ESRD) and urothelial tumors.
Area of Science:
- Toxicology
- Nephrology
- Oncology
Background:
- Ochratoxicosis, a condition caused by ochratoxin A, is a potential health concern.
- The link between ochratoxin A exposure and renal disease, including end-stage renal disease (ESRD) and urothelial tumors, requires further investigation, particularly in Egypt.
Purpose of the Study:
- To investigate the prevalence and correlation of ochratoxin A in patients with various renal conditions and urothelial tumors in Egypt.
- To assess the potential role of ochratoxin A in the pathogenesis of ESRD and urothelial cancers.
Main Methods:
- A comparative study involving seven groups: ESRD patients (on conservative treatment and hemodialysis), renal allograft recipients, nephrotic syndrome patients, urothelial tumor patients, potential kidney donors, and healthy controls.
- Laboratory, radiological, and histopathological evaluations of kidney status.
- Quantification of ochratoxin A levels in serum, urine, and tissue biopsies (for urothelial tumor group).
Main Results:
- Significantly elevated serum ochratoxin A levels were observed in patients with ESRD (groups 1 and 2) compared to reference groups.
- Ochratoxin A was detected in serum and urine of renal transplant recipients (group 3) and nephrotic syndrome patients (group 4), with higher levels in the latter.
- Positive ochratoxin A detection in serum, urine, and tissue biopsies of patients with urothelial tumors (group 5).
Conclusions:
- Ochratoxin A exposure is strongly correlated with the development of renal disease leading to ESRD.
- Ochratoxin A may play a role in the genesis of urothelial cancer.
- Further comprehensive research on ochratoxicosis and its causal relationship with renal diseases in Egypt is recommended.