title: Therapeutic remedies based on Aristolochia clematitis in the main foci of Balkan endemic nephropathy in Romania.
abstract: Balkan endemic nephropathy (BEN) is a disease found in Romania and neighboring countries in the Balkan area. In Romania, BEN is most prevalent in Mehedinti County, located in the South of Romania near the Danube River. The etiology of the disease is as yet unknown. One of the current hypotheses concerning BEN etiology is an involvement of aristolochic acid (AA). BEN bears many similarities to aristolochic nephropathy, which is developed due to the use of Chinese herbs as therapeutic remedies in slimming diets. This paper analyzes the involvement of therapeutic remedies based on AA in the BEN found in Mehedinti County, where these herbs have been traditionally used. The presence of AA in the plasma of BEN patients as well as of other subjects, including healthy relatives of these patients and other persons from the BEN-affected area, has been analyzed. No AA was detected in the plasma of the studied subjects. This proves the absence, at the current time, of an AA contribution in the analyzed subjects. Therapeutic remedies based on AA have been used in the BEN-affected area. We were not able to reveal direct relationships between these remedies and either the development of BEN in dialyzed patients or the development of urinary-tract tumors in dialyzed patients with urothelial tumors. Therapeutic remedies based on Aristolochiaclematitis may play a stimulating role in BEN with regard to its development and the development of urinary-tract tumors. There may be a relationship between BEN and cumulative previous exposure to low doses of AA due to the consumption of contaminated foodstuffs, which could add to any contributions by therapeutic remedies.
authors.affiliation: Department of Nephrology, Victor Babeş University of Medicine and Pharmacy, Timişoara, Romania. ggluhovschi@yahoo.com
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Gluhovschi
authors.forename: Florin
authors.initials: F
authors.lastname: Margineanu
authors.forename: Adriana
authors.initials: A
authors.lastname: Kaycsa
authors.forename: Silvia
authors.initials: S
authors.lastname: Velciov
authors.forename: Cristina
authors.initials: C
authors.lastname: Gluhovschi
authors.forename: Flaviu
authors.initials: F
authors.lastname: Bob
authors.forename: Ligia
authors.initials: L
authors.lastname: Petrica
authors.forename: Gheorghe
authors.initials: G
authors.lastname: Bozdog
authors.forename: Simona
authors.initials: S
authors.lastname: Dumitru
authors.forename: Elisabeta
authors.initials: E
authors.lastname: Olosz
authors.forename: Mirela
authors.initials: M
authors.lastname: Modalca
mesh_terms: D030022:Aristolochia; D034341:Aristolochic Acids / Q000008:administration & dosage / Q000009:adverse effects* / Q000302:isolation & purification; D001449:Balkan Nephropathy / Q000097:blood / Q000139:chemically induced* / Q000453:epidemiology*; D001628:Beverages / Q000009:adverse effects*; D003625:Data Collection / Q000379:methods; D005260:Female; D006801:Humans; D010936:Plant Extracts / Q000008:administration & dosage / Q000009:adverse effects* / Q000302:isolation & purification; D018515:Plant Leaves; D012383:Romania / Q000453:epidemiology
chemical_list: D034341:Aristolochic Acids; D010936:Plant Extracts; C000228:aristolochic acid I