1. ¹National Center of Public Health Protection, Sofia, Bulgaria
2. ²Vratza District Hospital, Vratza, Bulgaria
3. ³Department of Epidemiology and Biostatistics, University of South Carolina, Columbia, South Carolina, USA

Correspondence: P Dimitrov, National Center of Public Health Protection, 15 'Acad. Ivan Geshov' Blvd., Sofia 1431, Bulgaria. E-mail: p.dimitrov@ncphp.government.bg

Received 26 April 2005; Revised 10 June 2005; Accepted 21 September 2005; Published online 11 January 2006.

Abstract

Balkan Endemic Nephropathy (BEN) is a kidney disease that progresses slowly. Only a few studies have investigated renal clinical markers in offspring of BEN families before the onset of the disease. This project aimed to determine whether kidney function and structure are altered in BEN offspring compared with non-BEN offspring. The study population consisted of 102 adult BEN offspring and a control group of 99 non-BEN offspring. We collected urine and blood samples, and conducted face-to-face interviews, physical examinations and ultrasound measurements of the kidney. Total protein, albumin, ₂-microglobulin and creatinine in urine, creatinine and urea in serum, and creatinine clearance (CCR) were determined. Two risk factors were assessed: first, the overall status of being an offspring from a BEN family, and second, the specific status of a mother and/or father with BEN. The data were analyzed using linear regression. After adjusting for confounders, we found that kidney length and minimal cortex width in BEN offspring were significantly decreased. Urine concentrations of total protein, albumin, and ₂-microglobulin were higher in BEN offspring. Regarding parental history, the associations were statistically significant only for the offspring of mothers who had BEN, with the exception of minimal cortex width, which showed no parental difference. For CCR, we did not identify a statistically significant effect for BEN offspring status nor for parental history. In conclusion, adult offspring of BEN families can be characterized by shorter kidney length and an increased excretion of albumin, total protein, and ₂-microglobulin, in particular, when the mother had BEN.