Issue 4, 2009May 20, 2009 For the current Nephron Digest, I have chosen three papers from Nephron Clinical Practice, issue 112/2/09: One article deals with Balkan Endemic nephropathy, one focuses on kidney disease as a negative predictor of 30-day survival after acute ischaemic stroke, and the third investigates cardiorenal risk prevalence in sickle cell hemoglobinopathy. Many of the topics discussed in this issue of Nephron Clinical Practice will undoubtedly feature prominently at the forthcoming World Congress of Nephrology in Milan, Italy. Hope to see you there! Professor Meguid El Nahas, PhD, FRCP Editor, Nephron Clinical Practice nephron@sheffield.ac.uk m.el-nahas@sheffield.ac.uk   Digest of issue 2/2009 The review by Stefanovic and Polenakovic (Nephron Clin Pract 2009;112:c51-c56), two leading experts on Balkan Endemic Nephropathy (BEN), reminds readers of the link between BEN, uroepithelial cancer and toxins such as aristolochic acid (AA). In the Balkans, BEN may be associated with consumption of flour derived from wheat contaminated with Aristolochia clematitis which contains high levels of AA. Of note, in Asian countries, the complexity of processing of Chinese herbal remedies and the common substitution of botanical products by AA-containing herbs represents the major risk for AA-associated nephropathy. In Taiwan, regular users of Chinese herbal medicines have a 20% increased risk of developing CKD (Wen et al., Lancet 2008;371:2173-82). The study by Szymon Brzosko and colleagues from Bialystok, Poland (Nephron Clin Pract 2009;112:c79-c85) showed that decreased eGFR and presence of dipstick proteinuria were strong negative predictors of 30-day survival after ischemic stroke. This study confirms the negative cardiovascular disease (CVD) prognostic implications of CKD. It supports the growing impression that decreased kidney function and/or proteinuria in the elderly identify a subgroup with underlying subclinical atherosclerosis. A recently devised predictive scoring system, SCORED (SCreening for Occult REnal Disease), was shown to reliably predict recurrent CVD in heart attack and stroke patients, (Bang et al., Nephrol Dial Transplant 2009; March 26 - Epub ahead of print; doi:10.1093/ndt/gfp124). Abo-Zenah and colleagues from the Kingdom of Saudi Arabia (Nephron Clin Pract 2009;112:c98-c106) showed that markers of cardio-kidney-damage, such as albuminuria and atherosclerosis, were common findings in patients of Arabic descent with sickle cell haemoglobinopathies. They suggested that albuminuria could prove to be a useful screening tool to identify sicklers at risk for cardiovascular and renal events. Albuminuria is proving to be a useful marker of the well-known diffuse vascular endothelial dysfunction of patients with SCD (Morris, Hematology Am Soc Hematol Educ Program 2008;177-185).   © S. Karger AG - Medical and Scientific Publishers Allschwilerstrasse 10, P.O. Box, CH-4009 Basel (Switzerland) Tel. +41 61 306 1200, Fax +41 61 306 1234, publications@karger.ch. Please read the Karger Privacy Policy. If you have received this email by mistake, click here and we will take you off this mailing list.