Balkan nephropathy

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Overview
Balkan nephropathy (or Balkan endemic nephropathy) is a form of interstitial nephritis. It was first identified in the 1920s among several small, discrete communities along the Danube River and its major tributaries, in the modern countries of Croatia, Bosnia and Herzegovina, Serbia, Romania and Bulgaria. The most striking feature of the disease is its very localised nature. There are approximately ten small areas where it occurs, all of them more or less rural, but nothing seems to connect those areas other than the occurrence of this illness.

The etiology for Balkan nephropathy is currently unknown. . It has recently been hypothesized that chronic exposure to dietary aristolochic acid is a major risk for Balkan nephropathy. Aristolochic acid may come from Aristolochia clematitis, a plant native to the endemic region, and its seeds may comingle with wheat used for bread.