Evaluating weight of evidence in the mystery of Balkan endemic nephropathy.

摘要: Balkan endemic nephropathy (BEN) is a chronic, progressive wasting disease of the kidneys, in certain rural regions nations Croatia, Serbia, Bulgaria, and Romania. It irreversible ultimately fatal. Though this was first described 1950s, its causes have been mystery source much academic clinical contention. Possible etiologic agents that explored include exposure to metals metalloids, viruses bacteria, dietary toxins aristolochic acid (AA) ochratoxin A (OTA). AA toxin produced by weeds genus Aristolochia, common wheat fields. Aristolochia seeds may intermingle with harvested grains thus inadvertently enter human diets. OTA mycotoxin (fungal toxin) many foods, including cereal grains. In study, we analyzed weight evidence for each suspected BEN using Bradford Hill criteria (BHC): nine conditions determine causal relationship between an agent disease. Each postulated cause evaluated criteria, criterion given rating based on strength association substance BEN. From overall available scientific these risk factors, greatest causing We describe other methods testing causality from epidemiological studies, which support conclusion