Balkan nephropathy

Description

Balkan nephropathy is a form of interstitial nephritis characterised by a very localised geographic occurrence. It was first identified in the 1920s among several small, discrete communities along the Danube River and its major tributaries. Now thought to be due to chronic aristolochic acid ingestion (ingestion of Aristolochia clematitis seeds native to the Balkan region), though it has some differences from Chinese herbal nephropathy. This disease is characterised by renal insufficiency, proteinuria, tubulointerstitial nephritis, anaemia, weakness, copper discoloration of the skin, and may lead to end-stage renal disease within 5 years after onset.

Inclusions

• Balkan endemic nephropathy

Exclusions from above levels

• GB70 – calculous pyelonephritis (NFAD)
• 4A43.2Y – Sjögren syndrome with renal tubulo-interstitial disorders
• 4B22 – Renal tubulo-interstitial disorders in simple cryoglobulinaemia