Malignant diseases of urinary tract in the Balkan countries.

Abstract

Endemic nephritis affects the population in villages along some rivers in the Balkan countries: Bulgaria, Yugoslavia and Rumania. This is a chronic kidney disease with a malignant course leading to uremia and death. In autopsy material the kidneys were small and dehydrated, and the focal inflammatory and sclerogenous lesions on the interstitium and the atrophic and necrotic lesions on the renal parenchyma were registered histopathologically. In autopsy of dead subjects, whose death was caused by endemic nephritis, Bulgarian authors found the following tumors: polyps, papillocarcinomas and carcinomas, in one third of autopsy material. Yugoslav authors point out the occurrence of tumors which follow the endemic nephritis of the upper urothelium or urinary tract. The conditions of occurrence of these diseases of the urinary tract have been created during last decades, in the Balkan countries, owing to fast and intensive denudation of some mountain regions composed of silicate magmatic rocks. In the erosive processes, these rocks have been broken and crumbled into particles and had been taken away as erosive deposits in mountain rivers and streams. During a period of rich precipitations and high water levels, these erosive silicates from rivers’ deposits penetrate into drinking water in some populated settlements along rivers, and the farmers living there have been drinking the river filtrate temporarily as fresh silicate micron suspension. This silicate suspension in the human organism is decomposed in a slightly alkaline reaction of the blood and by release of silicic acid which has a toxic property in its excretion in kidneys in acidous condition of interstice and tubuli. Its toxiceffect on the kidney is double: diffuse, dystrophicatrophic on the parenchyma and focal inflammatory-proliferative on the interstice. For a long period of temporary exposure to the effect of silicic acid the kidney becomes fibrous, dehydrated and reduced to such a measure that in some extreme cases, on autopsy material, the weight of kidneys was 20 g. In decomposition of silicate suspension in the human organism the other components of magmatic silicate rocks bicoms hemically active and we cannot answer to the question of their effect on the urinary tract in excretion.