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Update on endemic nephropathies

Wernerson, Annika; Wijkström, Julia; Elinder, Carl-Gustaf

Current Opinion in Nephrology and Hypertension: May 2014 - Volume 23 - Issue 3 - p 232–238
doi: 10.1097/01.mnh.0000444911.32794.e7

Purpose of review A large number of patients worldwide suffer from chronic kidney disease (CKD) of unknown cause. Endemic nephropathies possibly contribute to this. The purpose of this review is to give a brief review of endemic nephropathies and to summarize what is known about their cause.

Recent findings The cause of Balkan endemic nephropathy was eventually resolved, after 50 years of research. The cause was exposure to aristolochic acid from food. A new type of endemic nephropathy has recently been identified in Central America; Mesoamerican nephropathy. This kidney disease mainly affects agricultural workers in hot climates. Renal biopsy studies suggest that repeated dehydration and kidney ischemia is involved in the pathogenesis.

Summary Endemic nephropathies may comprise an important cause of CKD. Epidemiological studies are needed to describe the occurrence and distribution of the diseases. However, biopsy studies, in combination with careful clinical evaluation of the patients, are necessary to find out the cause of endemic nephropathies and thereby help in their prevention.

Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden

Correspondence to Annika Wernerson, MD, PhD, Clinical Pathology and Cytology F46, Karolinska University Hospital, Huddinge, S-14186, Stockholm, Sweden. Tel: +46 858580000; fax: +46 858581020, e-mail:

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