Kidney pathology in endemic nephropathy

Histopathologic analysis was made of kidneys from seven cases of typical endemic nephropathy and five cases of probable endemic nephropathy or upper urinary tract carcinoma from Yugoslavia. Glomeruli usually had an increased mesangial matrix and abnormal lobulation, sometimes with vacuolar degeneration. Particularly the straight ascending, descending and Henle loop tubules showed increased epithelial degeneration and regeneration. A network of interstitial scars and a subcapsular stratum of notable cortical degeneration contributed to severe renal atrophy. Unusual intrarenal vein thickening with or without obliteration was notable. Reactive glomerular, Bowman's epithelial and convoluted tubular alterations were ascribed to a filtered toxic material with carcinogenic properties which was considered eventually responsible for renal atrophy, fibrosis and some attributes of an autoimmune reaction.