Pagina's

Mycotoxin-Induced Chronic Kidney Disease

In Tunesia, a chronic kidney disease of unknown etiology was first described in 2003[1]. It resembled in many ways other Chronic Kidney Diseases of non-Traditional causes, especially Aristologic Acid Related Chronic Kidney Disease. After an insidious course, patients present in their fourth or fifth decade with End-Stage Renal Failure (ESRF)[2].

However, while the cause of Aristologic Acid Related Chronic Kidney Disease has been resolved as being grain contaminated with (European) birthwort (Aristolochia clematis) or fytotherapeutic medicins, containing one or more species of Aristolochia, the exact cause of Tunesia's chronic kidney disease of unknown etiology remained a mystery.
[Ochratoxin A as seen under an electron microscope]

In Tunesia, food contamination with ochratoxin A, a mycotoxin produced by Aspergillus ochraceus, Aspergillus carbonarius or Penicillium verrucosum, is widespread[3]. Ochratoxin A can orrur in cereal grains, dry beans, grapes, moldy peanuts and coffee beans. Serum ochratoxin levels are higher in patients with Chronic Kidney Diseases of non-Traditional causes (CKDnT) than in those in the control group[4].

Despite this, not all that were heavily exposed develop Chronic Kidney Disease. Researchers speculate that a genetic predisposition might be involved, but it might be simpler than that: silica dust is a known cause of Chronic Kidney Diseases.

I propose to call this Chronic Kidney Disease of non-Traditional causes (CKDnT): Mycotoxin-Induced Chronic Kidney Disease.

[1] Abid et al: Ochratoxin A and human chronic nephropathy in Tunisia: is the situation endemic? in Human and Experimental Toxicology – 2003
[2] Hmaissia Khlifa et al: Ochratoxin A levels in human serum and foods from nephropathy patients in Tunisia: where are you now? in Experimental and Toxicologic Pathology – 2012
[3] Creppy et al: How much should we involve genetic and environmental factors in the risk assessment of mycotoxins in humans? in International Journal of Environmental Research and Public Health – 2005
[4] O'Brien, Dietrich: Ochratoxin A: the continuing enigma in Critical Reviews in Toxicology – 2005

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