Human ochratoxicosis and nephropathy in Egypt: A preliminary study

Abstract

This preliminary study was designed to delineate the extent of the problem of ochratoxicosis and its relation to renal diseases mounting to end stage renal disease (ESRD) or urothelial tumors in Egypt. It comprised 71 patient with renal diseases of different presentations. They were divided into five groups: (group I - no.=11) patients with (ESRD)under conservative treatment, (group 2 - no.=15) ESRD on regular hemodialysis, (group3 - no.= 15) renal allograft recipients, (group 4 - no.=15) patients with nephrotic syndrome and (group 5 - no.=15) patients with urothelial tumors. In addition, two control groups were included; potential related donors for renal transplantation (group 6 - no.=15) and healthy controls with negative family history of renal disease (group 7 - no.=25).

All groups were subjected to clinical, laboratory, radiological and histopathological evaluation of renal status together with determination of ochratoxin A level in blood, urine and in biopsy specimens of patients with urothelial tumors.

High ochratoxin blood levels were found in all patients with ESRD (groups 1 & 2) (p<0.01). Higher blood levels were detected in the group on conservative treatment (group 1) in comparison to controls possibly due to ochratoxin A clearance bydialysis. Ochratoxin A was detected in blood andurine of renal transplant recipients (group3) (p<0.01)and especially higher levels were found in patientswith nephrotic syndrome (group 4) (p<0.001). Patients with urothelial tumor (group 5), had higher levels of ochratoxin in blood, urine and tissue biopsy specimens (p<0.01).

These results support the conclusion that ochratoxin-A could be related to the genesis of renal disease leading to ESRD or causing urothelial cancer. We recommend more detailed study for ochratoxicosis & renal disease in Egypt.