Balkan nephropathy diagnosis

During initial Balkan nephropathy research, patients were frequently in their thirties [14], and it was widely accepted that azotemia usually affects the age group 30-50 [3]. Later an apparent shift towards the older ages occurred, with most identified patients being above the age of 60 [9]. The diagnosis of clinical forms before the age of 20 was rare and never independently confirmed. Despite occasional statements on laboratory and bioptic abnormahties in the first decade of life among clinically healthy children from endemic areas, no follow up study ever showed that these children developed subsequently kidney disorder. 

The diagnosis of Balkan nephropathy is now established according to the first two criteria (residence in... 

Histopathological analysis makes the diagnosis of Balkan nephropathy significantly easier [72,79], and it is considered indispensable in classifying the following groups of patients with urinary abnormalities suggestive of endemic nephropathy ... 

So far, laboratory studies have failed to detect any disorder as a specific marker for early detection of the disease or a reliable indicator for differential diagnosis. Laboratory studies have confirmed that Balkan nephropathy is a tubulointerstitial disease so that tubular disorders precede impairment of glomerular... 

Savin M, Bumbasirevic V, Djukanovic Lj, Petronic V. The significance of apoptosis for early diagnosis of Balkan nephropathy. Nephrol Dial Transplant 2001 16(Suppl 6) 30-32. 

The most commonly used criteria for the diagnosis of Balkan nephropathy are those proposed by Danilovic et al [99]. They include (1) farmers in the endemic villages, (2) familial history positive for endemic nephropathy, (3) mild proteinuria, (3) low specific gravity of the urine, (4) anemia, early occurrence, normochromic or hypochromic, (5) retention of nitrous compounds in the blood (urea > 50 mg/dl, creatinine > 1.5 mg/dl), (6) symmetrically shrunken kidneys. Using these criteria, Danilovic classified patients into the following groups ... 

So far, laboratory studies have failed to detect any disorder as a specific marker for early detection of the disease or a reliable indicator for differential diagnosis. Laboratory studies have confirmed that Balkan nephropathy is a tubulointerstitial disease so that tubular disorders precede impairment of glomerular filtration. Although anemia is one of the criteria for the diagnosis of the disease, it has not been evidenced that pathogenesis and features of this anemia differ from that observed in other chronic renal diseases. It is only more severe in end-stage Balkan nephropathy patients than in patients with other kidney diseases. 

A stronger tendency towards applied research has always been a part of Prof. VuCelid s character. Hence, in the past few years he has tried to apply pure biophysical methods to medical research. This has resulted in a new method for the diagnosis of skin diseases based on the propagation of acoustic waves through complex skin interphases and to a new hypothesis about the cause of Balkan nephropathy. 

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