Journal
ANNALS OF INTERNAL MEDICINE
Volume 158, Issue 6, Pages 469-477Publisher
AMER COLL PHYSICIANS
DOI: 10.7326/0003-4819-158-6-201303190-00006
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Funding
- Association for International Cancer Research
- NIHR Clinical Lectureship
- Kidney Research UK
- NIHR Biomedical Research Centre at Guy's and St Thomas' NHS Foundation Trust
- NIHR Biomedical Research Centre at King's College London
- Cancer Research UK
- Cancer Research UK [14329] Funding Source: researchfish
- Medical Research Council [MR/J006742/1, G0801056B] Funding Source: researchfish
- National Institute for Health Research [CL-2010-17-010] Funding Source: researchfish
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It has been 20 years since the first description of a rapidly progressive renal disease that is associated with the consumption of Chinese herbs containing aristolochic acid (AA) and is now termed aristolochic acid nephropathy (AAN). Recent data have shown that AA is also the primary causative agent in Balkan endemic nephropathy and associated urothelial cancer. Aristolochic acid nephropathy is associated with a high long-term risk for renal failure and urothelial cancer, and the potential worldwide population exposure is enormous. This evidence-based review of the diagnostic approach to and management of AAN draws on the authors' experience with the largest and longest-studied combined cohort of patients with this condition. It is hoped that a better understanding of the importance of this underrecognized and severe condition will improve epidemiologic, preventive, and therapeutic strategies to reduce the global burden of this disease. Ann Intern Med. 2013; 158: 469-477.
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