title: The epidemiology, diagnosis, and management of aristolochic acid nephropathy: a narrative review.
abstract: It has been 20 years since the first description of a rapidly progressive renal disease that is associated with the consumption of Chinese herbs containing aristolochic acid (AA) and is now termed aristolochic acid nephropathy (AAN). Recent data have shown that AA is also the primary causative agent in Balkan endemic nephropathy and associated urothelial cancer. Aristolochic acid nephropathy is associated with a high long-term risk for renal failure and urothelial cancer, and the potential worldwide population exposure is enormous. This evidence-based review of the diagnostic approach to and management of AAN draws on the authors' experience with the largest and longest-studied combined cohort of patients with this condition. It is hoped that a better understanding of the importance of this underrecognized and severe condition will improve epidemiologic, preventive, and therapeutic strategies to reduce the global burden of this disease.
authors.affiliation: King’s College London and Imperial College London, London SE1 9RT, United Kingdom.
authors.forename: M Refik
authors.initials: MR
authors.lastname: Gökmen
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Cosyns
authors.forename: Volker M
authors.initials: VM
authors.lastname: Arlt
authors.forename: Marie
authors.initials: M
authors.lastname: Stiborová
authors.forename: David H
authors.initials: DH
authors.lastname: Phillips
authors.forename: Heinz H
authors.initials: HH
authors.lastname: Schmeiser
authors.forename: Monique S J
authors.initials: MS
authors.lastname: Simmonds
authors.forename: H Terence
authors.initials: HT
authors.lastname: Cook
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Vanherweghem
authors.forename: Joëlle L
authors.initials: JL
authors.lastname: Nortier
authors.forename: Graham M
authors.initials: GM
authors.lastname: Lord
mesh_terms: D034341:Aristolochic Acids / Q000009:adverse effects*; D001449:Balkan Nephropathy / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans; D007674:Kidney Diseases / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D028321:Plant Preparations / Q000009:adverse effects*; D012307:Risk Factors; D014571:Urologic Neoplasms / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy
chemical_list: D034341:Aristolochic Acids; D028321:Plant Preparations; C000228:aristolochic acid I