Since it was first formally recognised in 1956, the disease called endemic Balkan nephropathy has perplexed experts, who have considered various explanations, including groundwater contamination.
Unlike most patients with kidney failure, people with the Balkan illness often have healthy blood pressure. Nonetheless, as their kidneys begin to fail they require dialysis and about half of them eventually develop a rare cancer of the upper urinary tract.
Arthur Grollman, at the University at Stony Brook, New York, US, did not expect to discover birthwort as the cause of this kidney disease when he set out for the region a few years ago. Instead, he had hypothesised that herbal remedies were to blame for this nephropathy.
[... H]e surveyed patients in dialysis clinics in the region on whether they had taken any herbal medicines. But none reported taking such supplements.
Disappointed his theory had proved wrong, Grollman headed for home – but not before killing a final afternoon in a library in Zagreb, the Croatian capital.
There, he came across a striking description from the 1930s about how horses in the region had developed kidney failure after grazing on a plant known as Aristolochia clematis, also known as birthwort. Grollman immediately cancelled his flight and set off to meet Balkan farmers.
A survey of their fields and mills revealed that some of their wheat was indeed contaminated with Aristolochia clematis seed. Back in the lab, Grollman and his colleagues examined kidney samples from Croatian nephropathy patients. They found the same telltale signs of DNA damage linked to Aristolochia clematis as seen in animal studies.
PlagueBlog recommends weeding the wheat.
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