Aristolochia clematitis, the herb responsible for aristolochic acid nephropathy, in an uncultivated piece of land of an Italian nephrologist

Abstract

Background. Aristolochia clematitis (AC), a herbaceous plant that belongs to the family of Aristolochiaceae, is today considered as being responsible for Balkan endemic nephropathy (BEN). Very scarce information is available in the medical literature about the presence of AC outside Balkan area. This article reports on the finding of AC in Northwest Italy and the results of a questionnaire delivered to locals on their knowledge about AC. Methods. AC was found in an uncultivated piece of land of a hilly area of Northwest Italy. It was identified by matching it with images available in the literature and Internet. The questionnaire, which was delivered with a set of 12 photographs and a bunch of true AC, contained 15 questions aimed at collecting information on the knowledge of the respondents about the existence, name, distribution and possible uses of AC. Results. A total of 23 locals, mostly farmers, were interviewed. Among them, 22 (95.6%) had already seen AC, mostly in uncultivated areas; 4 (18%) had a name for it; 21 (95.4%) considered it as a weed and denied any personal use of it; 18 (81.8%) stated that breeding animals disliked AC and no one was aware that AC might damage kidneys. Conclusions. This study demonstrates that AC can be found outside the Balkan region and that people know it but today do not make any use of it. Other studies carried out by nephrologists in other geographic areas could expand our knowledge about AC outside the basin of BEN.