Balkan Endemic Nephropathy Linked to Contaminated Drinking Water
A UNIQUE type of endemic kidney disease, originating in farming villages located along the Danube River in Balkan countries, is now thought to be a consequence of aristolochic acid contaminated water. This is according to a recent study carried out by Dr Wan Chan and colleagues from the Hong Kong University of Science and Technology, Kowloon, Hong Kong.
Recently, it was discovered that a weed local to the farming villages, Aristolochia clematitis L, was producing aristolochic acids, which are known to be potent kidney toxins. The link was made when people who had consumed A. clematitis medicinally were developing kidney disease. Dr Chan furthered this research questioning whether this plant is releasing these toxins into the soil and, if so, are the compounds leaching into the groundwater and contaminating the drinking water?
To answer this question, Dr Chan and his team tested 123 rural Serbian water samples using a positively charged silica-based sorbent, which is able to collect the negatively charged aristolochic acids. They then utilised liquid chromatography-tandem mass spectrometry to confirm the presence of the toxins. They found that the water from the drinking wells was polluted with ng/L levels of aristolochic acids, and also that these acids are long-lived in water systems, with no change in the concentration after 2 months of sample storage.
The authors are therefore calling for weed control of A. clematitis to reduce exposure during drinking, cooking, and irrigation and thereby decrease the incidence of Balkan endemic nephropathy. They are also advising that the 100 million people worldwide who use medicines similar to A. clematitis consider the results of this study and the potential nephrotoxins they may be exposing themselves to.