A modern approach to the concept of familial endemic nephropathy.

Complex epidemiological investigations carried out in the affected zone, enabled the author to notice that familial endemic nephropathy (FEN) starts, in the population, as an asymptomatic renal involvement which affects all the age groups from the first decade to the ninth, its incidence increasing with age. Clinically, early renal involvement represents the "silent" form of disease, predominant in urinary syndrome carriers, while progressive renal insufficiency (PRI) appears only as a late and irreversible accident, less frequent than the urinary syndrome. To explain renal involvement, the author suggests the presence of an inflammatory process as an initial pathogenetic impulse, while immunological activation - under the influence of stress factors - would explain the appearance of PRI.