Increased Glomerular Filtration Rate in Early Stage of Balkan Endemic Nephropathy

Background: A previous study indicated that Balkan endemic nephropathy (BEN) patients in the early stage of the disease had significantly higher creatinine clearance (Ccr) than healthy persons. The aim of the study was to assess whether tubular creatinine secretion affects Ccr in early stages of BEN and to check the applicability of serum creatinine-based glomerular filtration rate (GFR) equations in these patients. Methods: The study involved 21 BEN patients with estimated GFR (eGFR) above 60 mL/min/1.73 m(2), excluding any conditions that could affect GFR or tubular creatinine secretion, and 15 healthy controls. In all participants Ccr with and without cimetidine and iohexol clearance (mGFR) were measured and eGFR calculated using Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) and Modification of Diet in Renal Disease Study (MDRD) equations. Glomerular hyperfiltration cutoff (GFR-HF) was calculated. Results: There was no significant difference between the groups in Ccr before and after cimetidine or for eGFR, but mGFR was significantly higher in BEN patients than in controls (122.02 +/- 28.03 mL/min/1.73 m(2) vs. 101.15 +/- 27.32 mL/min/1.73 m(2); p = 0.032). Cimetidine administration reduced Ccr by 10% in both groups. The ratio of Ccr to mGFR was significantly above one in seven BEN patients and five controls and their mGFR values were similar. Seven other patients and eight controls had this ratio equal to one, while values below one were recorded for seven more patients and two controls. mGFR of all these 14 patients was significantly higher than that of healthy controls (129.88 +/- 27.52 mL/min/1.73 m(2) vs. 107.43 +/- 19.51 mL/min/1.73 m(2); p = 0.009). Mean GFR-HF was significantly higher than mGFR in controls, but these two values were similar in BEN patients. eGFR underestimated mGFR in both BEN patients and controls. Conclusion: The ratio of Ccr to mGFR and mGFR to GFR-HF indicated that elevated mGFR in early stages of BEN could be explained by increased glomerular filtration, but tubular creatinine secretion augmented Ccr in a smaller proportion of patients, who did not differ from healthy subjects

Transforming Growth Factor-beta(1) in Balkan Endemic Nephropathy

Background/Aim: The aim of this study was to compare plasma and urine transforming growth factor-beta(1) (TGF-beta(1)) levels in patients with different stages of Balkan endemic nephropathy (BEN) with those in patients with primary glomerulonephritis (GN) and healthy controls. Methods: The study involved 47 patients with BEN (30 with manifest BEN and 17 in the early stage of BEN), 12 patients with GN and 10 healthy controls. Plasma and urine TGF-beta(1) was assayed by enzyme-linked immunosorbent assay. Results: The median plasma TGF-beta(1) levels differed nonsignificantly between the groups (4,908-6,442 pg/ml), but individual plasma TGF-beta(1) levels in BEN patients exhibited the highest dispersion. Median urinary TGF-beta(1) excretion (pg/mg creatinine) was significantly higher in patient groups (manifest BEN: 203, early-stage BEN: 341, GN: 775) than in healthy controls (42). No correlation was found between plasma and urine TGF-beta(1) levels or between plasma TGF-beta(1) levels and creatinine clearance for any of the examined groups. Conclusion: Plasma TGF-beta(1) levels in BEN patients extended over the widest range, but no significant differences were found between the median values for the groups. Median urinary TGF-beta(1) excretion was significantly higher in patients with BEN and GN than in healthy controls. Copyright (C) 2009 S. Karger AG, BaselMinistry of Science and Ecology of Serbia [145037

Transforming Growth Factor-beta(1) in Balkan Endemic Nephropathy

Background/Aim: The aim of this study was to compare plasma and urine transforming growth factor-beta(1) (TGF-beta(1)) levels in patients with different stages of Balkan endemic nephropathy (BEN) with those in patients with primary glomerulonephritis (GN) and healthy controls. Methods: The study involved 47 patients with BEN (30 with manifest BEN and 17 in the early stage of BEN), 12 patients with GN and 10 healthy controls. Plasma and urine TGF-beta(1) was assayed by enzyme-linked immunosorbent assay. Results: The median plasma TGF-beta(1) levels differed nonsignificantly between the groups (4,908-6,442 pg/ml), but individual plasma TGF-beta(1) levels in BEN patients exhibited the highest dispersion. Median urinary TGF-beta(1) excretion (pg/mg creatinine) was significantly higher in patient groups (manifest BEN: 203, early-stage BEN: 341, GN: 775) than in healthy controls (42). No correlation was found between plasma and urine TGF-beta(1) levels or between plasma TGF-beta(1) levels and creatinine clearance for any of the examined groups. Conclusion: Plasma TGF-beta(1) levels in BEN patients extended over the widest range, but no significant differences were found between the median values for the groups. Median urinary TGF-beta(1) excretion was significantly higher in patients with BEN and GN than in healthy controls. Copyright (C) 2009 S. Karger AG, BaselMinistry of Science and Ecology of Serbia [145037

Investigation of Balkan endemic nephropathy in Serbia: How to proceed?

Balkan endemic nephropathy (BEN) presents an unsolved puzzle despite fifty years of its investigation. Academy of Medical Sciences of the Serbian Medical Society organized a round table discussion on current unsolved problems related to BEN. The present paper summarizes presentations, discussion and conclusions of this meeting. During the last fifty years, the course of BEN prolonged and it shifted towards the older age in all endemic foci. Data on the incidence of BEN have been controversial and frequently based on the data on the number of BEN patients starting haemodialysis treatment. In Serbia, BEN patients present 6.5% of haemodialysis population and this percentage differs among different centres ranging from 5% (Leskovac) to 46% (Lazarevac). Maintenance of high prevalence of BEN patients on regular haemodialysis indicates that BEN is not an expiring disease. In addition, recent data have shown more frequent microalbuminuria and low-molecular weight proteinuria in children from endemic than from nonendemic families. Aetiology of BEN is still unknown despite numerous investigations of environmental and genetic factors. Today, there is a very current hypothesis on the aetiological role of aristolochic acid but the role of viruses, geochemical factors and genetic factors must not be neglected. Morphological features of BEN are nonspecific and characterized by acellular interstitial fibrosis, tubular atrophy and changes on preand postglomerular vessels. New immunohistochemical and molecular biology methods offer a new approach to BEN investigation. Association of BEN with high incidence of upperurothelial tumours is well-known. Recent studies have shown significant changes of demographic characteristics of patients suffering upper-urothelial tumours, their prevalence in different endemic foci and characteristics of tumours. Further studies of BEN should be directed to determination of incidence and prevalence of disease in different endemic foci, investigations of different insufficiently examined aetiological factors as well as pathomorphological features of the disease by the use of modern methods

49. HRVATSKI I 9. MEĐUNARODNI SIMPOZIJ AGRONOMA: zbornik radova

Sadržaj: Plenarna izlaganja, Agroekologija, ekološka poljoprivreda i zaštita okoliša, Agroekonomika i ruralna sociologija, Genetika, oplemenjivanje bilja i sjemenarstvo, Povrćarstvo, ukrasno, aromatično i ljekovito bilje, Ratarstvo, Ribarstvo, lovstvo i pčelarstvo, Stočarstvo, Voćarstvo, vinogradarstvo i vinarstv

56th CROATIAN AND 16th INTERNATIONAL SYMPOSIUM ON AGRICULTURE: proceedings

Sadržaj: Plenarna izlaganja, Agroekologija, ekološka poljoprivreda i zaštita okoliša, Agroekonomika i ruralni razvoj, Genetika, oplemenjivanje bilja i sjemenarstvo, Povrćarstvo, ukrasno, aromatično i ljekovito bilje, Ratarstvo, Ribarstvo, lovstvo i pčelarstvo, Stočarstvo, Voćarstvo, Vinogradarstvo i vinarstvo, Poljoprivredna tehnik