Endemic Nephropathy

Endemic nephropathy is a family tubulointersitial chronic nephropathy, which occurs in hot spots, endemic, along the river Kolubara, Drina, Sava and Morava. It occurs in areas of South East Europe, and focus have been confirmed in Serbia, Bosnia and Herzegovina, Croatia, Romania and Bulgaria. The disease is clinically manifested in an adult rural population, typically between 30 and 50 years of age, with a slight predominance of females.

The cause of

Etiology of endemic nephropathy is unknown. The possible causes of stress are some elements that are found in traces (lead, cadmium, silicon), live agents (bacteria and viruses), fungal and plant toxins, genetic factors and immune mechanisms.

The clinical picture

Acute phase of illness does not exist. The disease is inconsiderable, relatively asymptomatic and very well tolerated, sometimes even decades. Weakness occurs only at the stage of renal failure, when the anemia is severe and when there is retention of nitrogenous products in blood. Patients complain of vague gastric discomfort. High blood pressure is encountered in about 30 - 40% of patients in advanced stages and in older patients. There is edema of renal origin.

The disease progresses to kidney failure and end-stage renal disease.

Diagnosis

It is based on medical history, epidemiological data, clinical presentation, objective examination, laboratory tests, ultrasound, intravenous urography, renal biopsy.

Treatment

For patients with nephropathy endemdske, whose etiology and pathogenesis are not yet known, consists mainly in higijenskodijetetski regime. Marked renal insufficiency requires hipoproteinski diet, correction of anemia, antihypertensives with existing hypertension in end-stage and active treatment (dialysis and transplantation).

Prevention

Comes down to taking general hygiene measures in terms of lifestyle, diet and drinking water supply from areas not affected.

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