Naslov
Natural Experiment with Bosnian Immigrants Who Settled Croatian Endemic Area – Final Epidemiological Evidence

Autori
Vuković-Lela, Ivana ; Karanović, Sandra ; Dika, Živka ; Kos, Jelena ; Cvitković, Ante ; Miletić- Medved, Marica ; Edwards, Karen ; Grollman, P.Arthur ; Jelakovic, Bojan

Vrsta, podvrsta i kategorija rada
Sažeci sa skupova, sažetak, znanstveni

Izvornik
Kidney Week 2013 JASN Abstract Supplement / - Atlanta (GA) : J Am Soc Nephrol, 2013, 663-664

Skup
Kidney Week 2013

Mjesto i datum
Atlanta (GA), Sjedinjene Američke Države, 05.11.2013. - 10.11.2013

Vrsta sudjelovanja
Poster

Vrsta recenzije
Međunarodna recenzija

Ključne riječi
endemic nephropathy; immigrants

Sažetak
Background: Endemic nephropathy(EN) represents a form of aristolochic acid nephropathy(AAN) where AA was ingested via contaminated bread. Improvement in agriculture that occurred in EN area 25 years ago signifi cantly decreased contamination of fl our with AA. A group of immigrants from Bosnian non-EN area settled Croatian EN area 30 years ago(BoEN). This is considered as period long enough for intake of cumulative toxic AA dose. However, due to mentioned improvement it can be supposed that they were no longer exposed to AA. To test this hypothesis we analyzed proximal tubule damage(PTD), an early hallmark of EN, and renal function in BoEN.Methods: 2347 farming villagers were enrolled and divided into 3 groups: autochthonous inhabitants of EN (CroEN ; N=1687) and of nonEN villages (Cro-nonEN ; N=372), and BoEN(N=102). Subjects were classifi ed according to consensus criteria. Defi nitions: PTD=1microglobuline/creatinine(1CR)>31.5 mg/g ; CKD=eGFR<60ml/min/1.73m2. Results: There was no difference in age, gender, BMI, BP, DM among groups(all p>0.05). 1CR values were signifi cantly lower in BoEN than in CroEN diseased and suspect to have EN (7.04 vs.102 vs.48 ; p<0.001) but did not differ from Cro-nonEN(7.39 ; p>0.05). Prevalence of PTD and CKD was lowest in BoEN compared to CroEN and nonEN (1.3% vs.3.0 vs.8.3% ; 5.9% vs.8.9% vs.15.8%, respectively ; p<0.001). No EN cases were detected in BoEN. Twenty years ago BoEN observed signifi cantly less A.clematitis in farming fi elds, less Aristolochia seeds among wheat seeds, and less frequently baked own bread (2 =21.6 ; 62.6 ; 31.7, respectively ; p<0.001). Conclusions: This natural experiment confi rmed our hypothesis that nowadays attenuated exposure to AA will lead to decrease in prevalence and probably to disappearance of EN.

Izvorni jezik
Engleski

Znanstvena područja
Kliničke medicinske znanosti

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