Toxins 2011, 3(7), 815-833; doi:10.3390/toxins3070815
Article

Comparative 1H NMR Metabolomic Urinalysis of People Diagnosed with Balkan Endemic Nephropathy, and Healthy Subjects, in Romania and Bulgaria: A Pilot Study

1 Centre for Environmental Policy, Imperial College London, London SW7 2AZ, UK 2 Dialysis Center (renamed Medical Service), Drobeta-Turnu Severin RO-220012, Romania 3 Investigative Preclinical Toxicology, GlaxoSmithKline R&D, Park Road, Ware, Herts SG12 0DP, UK 4 University of Medicine and Pharmacy, Timisoara RO-300708, Romania 5 Department of Medical Genetics, Medical University, Sofia 1431, Bulgaria
* Author to whom correspondence should be addressed.
Received: 30 May 2011; in revised form: 22 June 2011 / Accepted: 28 June 2011 / Published: 4 July 2011
(This article belongs to the Special Issue Uremic Toxins)
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Abstract: 1H NMR spectroscopy of urine has been applied to exploring metabolomic differences between people diagnosed with Balkan endemic nephropathy (BEN), and treated by haemodialysis, and those without overt renal disease in Romania and Bulgaria. Convenience sampling was made from patients receiving haemodialysis in hospital and healthy controls in their village. Principal component analysis clustered healthy controls from both countries together. Bulgarian BEN patients clustered separately from controls, though in the same space. However, Romanian BEN patients not only also clustered away from controls but also clustered separately from the BEN patients in Bulgaria. Notably, the urinary metabolomic data of two people sampled as Romanian controls clustered within the Romanian BEN group. One of these had been suspected of incipient symptoms of BEN at the time of selection as a ‘healthy’ control. This implies, at first sight, that metabolomic analysis can be predictive of impending morbidity before conventional criteria can diagnose BEN. Separate clustering of BEN patients from Romania and Bulgaria could indicate difference in aetiology of this particular silent renal atrophy in different geographic foci across the Balkans.
Keywords: Balkan nephropathy; metabolomics; urinalysis; haemodialysis; ochratoxin A; aristolochic acid

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MDPI and ACS Style

Mantle, P.; Modalca, M.; Nicholls, A.; Tatu, C.; Tatu, D.; Toncheva, D. Comparative 1H NMR Metabolomic Urinalysis of People Diagnosed with Balkan Endemic Nephropathy, and Healthy Subjects, in Romania and Bulgaria: A Pilot Study. Toxins 2011, 3, 815-833.

AMA Style

Mantle P, Modalca M, Nicholls A, Tatu C, Tatu D, Toncheva D. Comparative 1H NMR Metabolomic Urinalysis of People Diagnosed with Balkan Endemic Nephropathy, and Healthy Subjects, in Romania and Bulgaria: A Pilot Study. Toxins. 2011; 3(7):815-833.

Chicago/Turabian Style

Mantle, Peter; Modalca, Mirela; Nicholls, Andrew; Tatu, Calin; Tatu, Diana; Toncheva, Draga. 2011. "Comparative 1H NMR Metabolomic Urinalysis of People Diagnosed with Balkan Endemic Nephropathy, and Healthy Subjects, in Romania and Bulgaria: A Pilot Study." Toxins 3, no. 7: 815-833.

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