Gordana Boršo

Endemic nephropathy in Croatia.

Abstract Endemic nephropathy is a chronic renal disease with a high prevalence in a geographically limited area of Croatia. It has also been recorded in some parts of Bosnia, Serbia, Bulgaria and Romania. Despite numerous studies conducted to date, the etiology of this disease has not been clarified. Pathological studies of the kidney in the early stage of endemic nephropathy have shown renal tubules to be the primary sites of the pathologic process with an interstitial tissue reaction, whereas glomerular alterations are of a secondary character. Tubulointerstitial lesions can thus account for the symptoms of the disease, i.e. tubular proteinuria and reduced urine concentration capacity and urine acidification. Also, an increased incidence of malignant tumours of the urinary tract was found in the same geographic area.

Tamm-horsfall protein determination in Balkan endemic nephropathy

SummaryData on the excretion of Tamm-Horsfall protein (THP) in subjects living in an area of Balkan endemic nephropathy (BEN) are reported. The study subjects were divided into groups as follows: diseased, suspect, “at risk” and others, according to previously adopted criteria. The THP excretion in “at risk” subjects was found to be significantly higher as compared to control subjects. The difference between these two groups could not be registered by any other clinical or laboratory diagnostic methods. No difference in the excretion of THP was observed between the groups of others and control subjects. According to the results obtained, the excretion of THP may be considered a possibly useful additional diagnostic test for the detection of subjects with the latent, early subclinical phase of BEN. On the other hand, the data obtained shed some more light on the still obscure pathogenesis and natural history of BEN.