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It was found that in Belgium, renal imaging techniques, demonstrating a decreased renal mass of both kidneys combined with either bumpy contours or papillary calcifications, were the only methods to reliably diagnose analgesic nephropathy (AN) in patients with end-stage renal failure. However, these criteria were selected in an area with a high prevalence of this disease (15.6% of the dialysis population at December 1990). To evaluate the criteria selected to diagnose AN in populations with lower or unknown prevalences of AN, the Analgesic Nephropathy Network of Europe (ANNE) was formed, consisting of 23 dialysis units from 14 European countries and Brazil. During 1991–1992, 598 new patients with equivocal diagnosis of renal disease (excluding biopsy-proven glomerulonephritis, polycystic disease, diabetic nephropathy and other systemic diseases) and who began renal replacement therapy in the ANNE centres were evaluated by a short questionnaire and two renal imaging techniques: sonography and either tomography or computed tomography (CT) scan. A comparison of 82 abusers (daily use of analgesic mixtures for at least 5 years) and 495 controls corroborated the excellent diagnostic performance of the renal imaging techniques for AN. We recommend the use of these renal imaging criteria in all patients without a clear renal diagnosis in order to obtain a more reliable insight into the magnitude of the AN problem in different countries. [ABSTRACT FROM PUBLISHER]

The Balkan Cities Association of Nephrology, Dialysis, Transplantation and Artificial Organs (BANTAO) was born in Ohrid on October 9, 1993. The war in former Yugoslavia negatively affected the development of nephrology and also the connections among the nephrologists from the Balkans. However, there was willingness for further mutual collaboration between the nephrologists from the Balkans. The war in Yugoslavia created hate among people, between the newly established countries, and there were problems with the recognition of the names of the new countries, and so, the nephrologists decided to apply the ancient principle of using the names of the cities, instead of the countries, as the founders of the Association. The main goal of BANTAO is to promote scientific and technical cooperation in the fields of renal disease and artificial organs between the regions on the Balkan Peninsula and the world, to give an opportunity for exchange of experience and knowledge among the experts in the area and to engage in collaborative projects in order to demonstrate that cooperation is possible even on the turbulent Balkan Peninsula. The I BANTAO congress was held in Varna from September 22 to 24th, 1995 (President--D. Nenov, Varna). The II congress of BANTAO was held from September 6th to 10th, 1997 in Struga, (President--M. Polenakovic, Skopje). The III BANTAO congress was held in Belgrade from September 18th to 20th, 1998 (President--Lj. Djukanović, Belgrade). The IV congress of BANTAO was held in Izmir from 14th to 16th November 1999 (President--A. Akcicek, Izmir). The V Congress of BANTAO was held in Thessaloniki from September 30th to October 3rd, 2001 (President--P. Stathakis, Athens). The VI Congress of BANTAO was held for the second time in Varna from 6th to 9th October 2003 (President--D. Nenov, Varna). The VII congress of BANTAO was held from September 8th to 11th, 2005 in Ohrid, (President--M. Polenakovic, Skopje). The VIII BANTAO congress was held in Belgrade, 16-19 September 2007 (President--V. Nesic, Belgrade). The IX BANTAO congress was held in Antalya, 18-22 November 2009 (President--A. Basci, Izmir). The X BANTAO congress was held from 13 to 15 October 2011 in Chalkidiki (President--D. Tsakiris, Thessaloniki). The XI BANTAO congress is being held on 26-29 September 2013 in Timisoara (President--A. Schiller, Timisoara). At the VII BANTAO Congress for the first time a CME Course was organized by ERA/EDTA and ISN/COMGAN entitled "Frontiers in Nephrology" with seven distinguished speakers. Very important event in the existence of BANTAO is the appearance of the BANTAO journal in 2003. The BANTAO journal has been published biannually since 2003. In the past 10 years, 20 regular issues; 2 supplements (Antalia and Chalkidiki congresses) have been published. Editors of the journal were as follows: 2003-2005--D. Nenov, Editor; 2005-2009--A. Basci, Editor; 2009--Goce Spasovski, Editor. Until now 332 papers have been published. The BANTAO journal is on EBSCO, DOAJ, SCOPUS. After the First Congress of BANTAO, F. Valderrábano, chairman of the EDTA--ERA Registry, at that time, wrote in Nephrology Dialysis Transplantation (1996) 11:740: "Nephrologists of the Balkan countries meet across political frontiers and war fronts--an example to politicians!, Bantao: a new European Medical Association overcomes Political obstacles." Despite the difficulties imposed by major events, such as devastating wars and catastrophic earthquakes in many countries of the Balkan Peninsula BANTAO has made considerable progress. The BANTAO Congress was established as the major scientific and institutional forum for Balkan nephrologists, with its own journal, indicating our will to communicate, to collaborate, to get to know each other and to share our difficulties. Now, we expect further successful work of BANTAO.

The aim of the study is to examine influence of r-Hu-Ero on megakaryocytopoiesis in rats with depressed by dialysable substances thrombocytopoiesis. Experimental animals are male Wistar rats, treated with bidestilled water, used dialysis solution and r-Hu-Ero. We investigate bone marrow of experimental rats. More expressed increase of megakaryocyte count "pro mile" in rats with depressed megakaryocytopoiesis, as well as influence on megakaryocyte maturation for shorter period of time, provide evidence to be accepted that megakaryocytopoiesis, depressed by dialysable substances is more sensitive to stimulating effect of r-Hu-Ero. The reason for this enhanced sensitivity at present appear unclear.

Low prekallikrein is found in the plasma of patients with chronic renal failure (CRF) on intermittent haemodialysis (HD) (337 +/- 20.42 U/l before haemodialysis and 394.60 +/- 24.97 U/l after haemodialysis) versus normal data in the control group (755.80 +/- 24.37 U/l). Plasma activity of angiotensin converting enzyme (ACE) in patients with CRF is significantly decreased (14.91 +/- 0.57 U/l) in comparison to the control group (22.30 +/- 0.30 U/l). Intermittent haemodialysis increases plasma ACE activity. No differences exist after one haemodialysis procedure. There are no correlations between dialysis duration, plasma ACE activity, and prekallikrein. The ACE activity increase does not correlate with blood pressure but correlates significantly with the activation of complement and macrophage activity.

For the first time in Bulgaria and maybe in the world is reported very good therapeutic effect of the application of external drainage of the thoracic duct with and without lymphosorption in two consecutive cases of phalloid mushroom poisoning. Concrete indications are suggested for application of the method in this type of poisoning - in the late endotoxic phase of the poisoning when all other methods have been used with no effect.

The first results from the treatment of two cases with glomerulonephritis are reported--the first was an exacerbation of nephritis after intercurrent disease and second--with systemic lupus erythematosus, after plasmapheresis application as an active therapeutic method, in combination with corticosteroid cytostatic treatment. A reduction of the three immunoglobulins in plasma was found as a result from plasmapheresis and emergence of serum complement, together with clinical data for improvement of the patients. The prospects of plasmapheresis treatment of the active forms of glomerulonephritis are discussed.

The pre-kallikrein values, kallikrein inhibitors and protamine-splitting activity were determined in patients treated by means of chronic haemodialysis. Frequent use of dialysers leads to significant changes in the pre-kallikrein and kallikrein-inhibitor values. On the other hand the pre-kallikrein value remains unchanged after a single use of the capillary kidneys Hemoflow (Fresenius). A much smaller decrease in the kallikrein inhibitor value is observed than after frequent use of dialysers. In all the patients investigated the total protamine-splitting activity remained unchanged. Under these circumstances the inhibition capacity is probably sufficient to guarantee a control with respect to fibrinolysis, blood coagulation and the production of kinine.

A case with Wegener's granulomatosis in a young woman is described. The diagnosis was made after extirpation and histological investigation of granuloma tissue from the nasal concha and by needle renal biopsy. A successful treatment was carried out with plasmapheresis, hemodialysis and immune-suppressors, the acute paroxysm being coped as well as the developed acute renal insufficiency. After each plasmapheresis a considerable reduction of the circulating immune complexes was established. After a remission of 9 months the patient developed a stage of terminal chronic renal insufficiency and was subjected to chronic dialysis with good rehabilitation.

Plasma toxicity and plasma exchange efficacy were studied in two groups of patients: I gr.--8 patients with various degree of disturbed renal function who did not need hemodialysis treatment; II gr.--9 patients treated by periodic hemodialysis. A biologic toxicity test was used together with the clinical, immunologic and biochemical indices as a criterion for plasma exchange efficacy. The test gives direct information for the total plasma toxicity which is of great advantage and helps in the decision for another plasma exchange.

Three cases of acute intoxication with the preparation "Cistol", containing tetrachloro-methane were described, with the development of acute renal insufficiency, treated with hemodialysis. The attention of the physicians and the society is drawn to the risk of intoxication by that preparation. Early hemodialysis is recommended in case of such intoxications.

Prior to and post hemodialysis, a determination of plasma potassium, sodium, calcium, phosphorus and the indices of acid-base state is performed in 16 patients with chronic terminal renal insufficiency, with 560 hemodialyses, applied once or twice a week with deionized water and dialysis solution with 1, 5 mEq/1 potassium. Considerable hypopotassemia was established after hemodialysis--3, 3 mEq/1 and in 35% of the cases--hypopotassemia under 3.0 mEq/1. Metabolite alkalosis was established after dialysis: elevated pH in blood from 7,353 to 7,491; standard bicarbonates--from 21, 2 to 29, 1 m Eq/1; basis-excess: from (-3, 78) to (+5, 26) mEq/1; buffer bases: from 41, 3 to 51, 0 Eq/1, normalization of the elevated phosphorus in plasma from 7, 4 mg% to 4, 6 mg%. No significant changes in plasma sodium and potassium, as well as pCO2 were established after hemodialysis.