Endemic Balkan Nephropathy

  • Philip W. HallIII


Endemic Balkan nephropathy (EBN) is a unique form of chronic interstitial renal disease which is endemic to isolated rural populations of Bulgaria, Romania, and Yugoslavia. The area is confined within a 200-mile radius of Belgrade. The involved villages lie along river valleys in multiple areas of Romania and Yugoslavia where flooding periodically occurs (Wolstenholme and Knight, 1967). The disease is clinically characterized by the insidious onset of a normocytic, normochromic anemia, azotemia, and persistent proteinuria usually of <1 g/24 hr. There is no increase in the incidence of hypertension in the involved populations and the disease slowly progresses to end-stage renal failure over a period of 5–10 years following the onset of azotemia. While there is no uniform agreement concerning the early pathologic changes, it is generally accepted to be a chronic interstitial disease as it appears in the uremic patient. There is marked tubular atrophy with focal areas of tubular regeneration, interstitial fibrosis, and minimal round cell infiltration. The tissue loss is predominently cortical and most marked in the cortex opposite the hilum (Radonic et al., 1966).


Renal Tubular Acidosis Aristolochic Acid Endemic Balkan Nephropathy Endemic Focus Tubular Proteinuria 


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Copyright information

© Springer Science+Business Media New York 1982

Authors and Affiliations

  • Philip W. HallIII
    • 1
  1. 1.Department of MedicineCase Western Reserve University and Cleveland Metropolitan General HospitalClevelandUSA

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