How common is Balkan endemic nephropathy among immigrants in endemic regions?

Int Urol Nephrol. 2018 Jul;50(7):1301-1309. doi: 10.1007/s11255-018-1889-7. Epub 2018 May 19.

Abstract

Purpose: In the early 1970s, a number of authors described the development of Balkan endemic nephropathy (BEN) in immigrants in endemic regions. The aim of this study was to examine whether immigrants in endemic regions are suffering from BEN today.

Methods: The study involved 193 residents of two endemic regions divided into three groups: two groups of native residents-(1) members of BEN families, (2) members of non-BEN families, and (3) immigrants, who had moved from non-affected settlements to the endemic regions of Kolubara (38 years ago) or Semberia (20 years ago). All persons were subjected to an interview, objective examination, kidney ultrasound, and laboratory analysis to detect the presence of BEN consensus diagnostic criteria.

Results: The number of immigrants with BEN biomarkers outside cutoff values was significantly lower than for BEN family members. Five BEN family members met diagnostic criteria for BEN and four for suspected BEN. Although five non-BEN family members had different combinations of BEN biomarkers, all of them had diseases other than BEN in which these biomarkers also occurred. None of the immigrants met the criteria for BEN. Nevertheless, one descendant of an immigrant, a 78-year-old male, whose mother was from a non-BEN family in the Kolubara district, exhibited all the criteria for BEN: alpha1-microglobulinuria, chronic renal failure, and anemia.

Conclusion: While 30 years ago, BEN was reported equally among immigrants and natives, currently it is diagnosed in some BEN family members in the eighth decade of life, but extremely rarely in immigrants also in old age.

Keywords: Balkan endemic nephropathy; Immigrants; Native residents.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Balkan Nephropathy / diagnosis*
  • Balkan Nephropathy / epidemiology*
  • Balkan Peninsula / epidemiology
  • Disease Progression
  • Emigrants and Immigrants / statistics & numerical data*
  • Endemic Diseases
  • Female
  • Humans
  • Incidence
  • Kidney Failure, Chronic / epidemiology*
  • Kidney Failure, Chronic / physiopathology
  • Male
  • Middle Aged
  • Population Groups / statistics & numerical data*
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Survival Analysis