Vol. 9, No 1, 2002 pp. 7 - 14
UC 616.61-004
BALKAN ENDEMIC NEPHROPATHY IN BULGARIA
Tsvetan Dimitrov
Clinic of Nephrology, Medical Academy, Sofia, Bulgaria
Summary. Balkan endemic nephropathy (BEN) was described in Bulgaria,
in the district of Vratsa in 1956, and for more than 40 years this disease
has been the subject of extensive studies. In this review, the author describes:
geographic and physico-clinical characteristics of the endemic region,
epidemiology of BEN, etiology, pathomorphology and morphogenesis, clinical
picture, and one of the most interesting finding in BEN - the unusually
frequent combination of parenchymal renal injury and uroepithelial tumors
of the urinary tract. Most frequent are tumors of renal pelvis, followed
by tumors of ureter and urinary bladder. All these facts make BEN more
mysterious and interesting, and the efforts and means for clarifying its
nature and etiology are worthwhile.
On the basis of clinical, morphological and up-to-date etiologic studies
AN, CHN and BEN are separate chronic tubulointerstitial kidney diseases,
frequently associated with urothelial malignancy.
Key words: Balkan endemic nephropathy, epidemiology, etiology,
morphology, clinical features, urinary tract tumors
