Chronic dietary exposure to XXXX and kidney function in native farmers from a croatian endemic area and bosnian immigrants.

@entity1 @entity8 @entity5 @entity42845 @entity1011 @entity3505
BACKGROUND AND OBJECTIVES: Improvements in agricultural practices in Croatia have reduced exposure to consumption of @entity42845 -contaminated flour and development of endemic (Balkan) @entity8 . Therefore, it was hypothesized that Bosnian immigrants who settled in an endemic area in Croatia 15-30 years ago would be at lower risk of developing endemic @entity8 because of reduced exposure to @entity42845 . To test this hypothesis, past and present exposure to @entity42845 , proximal tubule damage as a hallmark of endemic @entity8 , and prevalence of CKD in Bosnian immigrants were analyzed. DESIGN, SETTING, @entity1 , _ MEASUREMENTS: In this cross-sectional observational study from 2005 to 2010, 2161 farmers were divided into groups: indigenous inhabitants from endemic @entity8 and nonendemic @entity8 villages and Bosnian immigrants; a-1 microglobulin-to- @entity1011 ratio >31.5 mg/g and eGFR<60 ml/min per 1.73 m(2) were considered to be abnormal. RESULTS: CKD and proximal tubule damage prevalence was significantly lower in Bosnian immigrants than inhabitants of @entity8 (6.9% versus 16.6%; P<0.001; 1.3% versus 7.3%; P=0.003, respectively); 20 years ago, Bosnian immigrants observed fewer Aristolochia clematitis in cultivated fields (41.9% versus 67.8%) and fewer seeds among @entity3505 seeds (6.1% versus 35.6%) and ate more purchased than homemade bread compared with Croatian farmers from @entity8 (38.5% versus 14.8%, P<0.001). Both Croatian farmers and Bosnian immigrants observe significantly fewer Aristolochia plants growing in their fields compared with 15-30 years ago. Prior @entity42845 exposure was associated with proximal tubule damage (odds ratio, 1.64; 95% confidence interval, 1.04 to 2.58; P=0.02), whereas present exposure was not (odds ratio, 1.31; 95% confidence interval, 0.75 to 2.30; P=0.33). Furthermore, immigrant status was an independent negative predictor of proximal tubule damage (odds ratio, 0.40; 95% confidence interval, 0.19 to 0.86; P=0.02). CONCLUSIONS: Bosnian immigrants and autochthonous Croats residing in endemic areas are exposed significantly less to ingestion of @entity42845 than in the past. The prevalence of endemic @entity8 and its associated @entity5 is predicted to decrease over time.
