Wernerson Annika, Wijkström Julia, Elinder Carl-Gustaf
Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Stockholm, Sweden.
Curr Opin Nephrol Hypertens. 2014 May;23(3):232-8. doi: 10.1097/01.mnh.0000444911.32794.e7.
A large number of patients worldwide suffer from chronic kidney disease (CKD) of unknown cause. Endemic nephropathies possibly contribute to this. The purpose of this review is to give a brief review of endemic nephropathies and to summarize what is known about their cause.
The cause of Balkan endemic nephropathy was eventually resolved, after 50 years of research. The cause was exposure to aristolochic acid from food. A new type of endemic nephropathy has recently been identified in Central America; Mesoamerican nephropathy. This kidney disease mainly affects agricultural workers in hot climates. Renal biopsy studies suggest that repeated dehydration and kidney ischemia is involved in the pathogenesis.
Endemic nephropathies may comprise an important cause of CKD. Epidemiological studies are needed to describe the occurrence and distribution of the diseases. However, biopsy studies, in combination with careful clinical evaluation of the patients, are necessary to find out the cause of endemic nephropathies and thereby help in their prevention.
全球大量患者患有病因不明的慢性肾脏病（CKD）。地方性肾病可能是其病因之一。本综述旨在简要介绍地方性肾病，并总结其已知病因。
经过50年的研究，巴尔干地方性肾病的病因最终得以明确。病因是食物中含有马兜铃酸。最近在中美洲发现了一种新型地方性肾病；中美洲肾病。这种肾病主要影响炎热气候地区的农业工人。肾活检研究表明，反复脱水和肾脏缺血参与了其发病机制。
地方性肾病可能是CKD的一个重要病因。需要进行流行病学研究来描述这些疾病的发生和分布情况。然而，活检研究结合对患者的仔细临床评估，对于找出地方性肾病的病因并从而有助于预防这些疾病是必要的。
