Differential diagnosis of some forms of chronic tubulointerstitial nephropathies associated with urothelial carcinoma

	Aristolochic acid nephropathy		Analgesic nephropathy
	Chinese herb nephropathy	Balkan endemic nephropathy	Analgesic nephropathy
Etiology	Aristolochic acid		Analgesics + addictive substances
Progression to ESRD	6 months to 2 years	>20 years	>10 to 15 years
Kidney imaging	Shrunken Irregular contours No calcifications	Shrunken Smooth surface No calcifications	Shrunken Irregular contours Papillary necrosis-calcifications
Histology
Cellular infiltration	+	+	++
Fibrosis	++	++	++
Atrophy	++	+++	++
Capillarosclerosis	+	+	+
Apoptosis	++	++	?
Urothelial malignancies	+ Upper tract	+ Upper tract	+ (*)
Familial occurrence	-	+	-

ESRD: end-stage renal disease.
* As long as phenacetin was part of the analgesic mixtures.

Adapted by permission from: Macmillan Publishers Ltd: De Broe ME. Chinese herbs nephropathy and Balkan endemic nephropathy: toward a single entity, aristolochic acid nephropathy. Kidney Int 2012; 81:513. Copyright © 2012.

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خرید پکیج

Differential diagnosis of some forms of chronic tubulointerstitial nephropathies associated with urothelial carcinoma