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• W2864172246 abstract "Introduction Balkan endemic nephropathy (BEN) is a tubulointerstitial nephropathy, which evolves to symmetric kidney atrophy, renal failure and frequent upper urinary tract malignancies. Patients’ survival is conditioned by dialysis or renal transplantation. The causative agent is considered to be aristolochic acid, but the mode of natural exposure in the endemic Danube region (Romania, Bulgaria, Serbia, Croatia, Bosnia) was not exactly established. In Romania no confirmatory studies have been done so far, but the endemic area is considered to be the rural localities from Mehedinți and Caraș Severin counties. The purpose of this study was to describe the epidemiological characteristics of Mehedinți BEN cases in order to create the premises for future studies about disease's determinants identification, the ways for achieving the exposure in the natural environment and suggesting paths to identify possible diagnostic criteria in an early stage of the disease. Method A cross-sectional study was conducted between July and September 2009, including the patients diagnosed with BEN and assisted in three dialysis centres from Drobeta Turnu-Severin. Data were collected using an original questionnaire, which included demographic data, symptomatology and investigations. Statistical analysis with descriptive indicators was performed in Epi info and Excel. Results A total of 74 patients were included in the study sample being in dialysis treatment in all three Drobeta Turnu-Severin dialysis centres. Patients, more women than men (gender ratio male to female of 0.81), were aged between 38 and 83 years, with an average age of 66.2 ± 9.5 years (± standard deviation: SD). They lived different time period in 38 villages in Mehedinti County, except for only one patient. Only in endemic area lived 57.7% of BEN patients and 22.6% of them have had interposed periods of staying in outside area. Others, 19.7% of them, after having originally lived in the endemic area, they permanently moved to non-endemic areas where they developed the disease. The mean age at diagnosis was 58.2 ± 11.5 years (range: 23–79 years), in men 59.4 ± 11 years (range: 23–71), and in women 57.5 ± 11.8 years (range: 33–79), without significant differences (P = 0.532) between the two genders. If in those living continuously in the endemic area BEN was diagnosed at an average age of 57.8 ± 11.6 years (range: 23–75 years), in the others who permanently left the endemic area the disease appeared after an average of 40.4 years (range: 10–69 years) after leaving the area, respectively to an average age of 59 ± 11.7 years (range: 33–79 years), differences being insignificant (P > 0.05) as time interval. Symptomatology reported by patients before diagnosis was installed slowly, with the most frequent being asthenia (93.1%), nycturia (81.9%), inappetence (77.8%), nausea (59.7%), polydipsia (54.2%), vomiting (52.8%), dysuria (45.8%). Of the laboratory parameters, beside those revealing renal dysfunction, consistently low values for hemoglobin (64.9%), erythrocytes (81.1%) and hematocrit (86.5%) were reported in patients. Concomitant malignancies had 11 patients (14.9%), mainly as urinary tract tumours. One patient had lung cancer, one colorectal and one ovarian cancer. Conclusions BEN affects only adult persons who live or have lived in the endemic area, especially in the 60th and 70th decade of life, regardless of their gender. Installation of the disease was similar regardless of whether or not the person left the endemic area. Patients presented as main associated pathology anemia and malignancies of urinary tract and other localizations." @default.
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• W2864172246 date "2018-07-01" @default.
• W2864172246 modified "2023-10-14" @default.
• W2864172246 title "Patients with Balkan endemic nephropathy from Mehedinti County, Romania: An epidemiological approach" @default.
• W2864172246 doi "https://doi.org/10.1016/j.respe.2018.05.207" @default.
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