Ochratoxin A is nephrotoxic and has been implicated in the genesis of
Balkan endemic nephropathy (BEN), a condition that leads to
end-stage renal disease and upper urothelial tumours. This compound induces renal parenchymal
carcinoma in male mice only, and is not considered to be a potent
carcinogen nor is there experimental evidence of its propensity to cause upper urothelial
carcinoma. There is, however, evidence that exposure to more than one
mycotoxin may be an important factor in the clinical spectrum of BEN.
Analgesic nephropathy is clinically different, but is also associated with an upper urothelial
carcinoma. The combination of urothelial initiation and an acute papillary
necrosis in rats produces upper urothelial
carcinoma. This two-stage experimental model offers the potential to assess the role of
ochratoxin A in BEN-associated upper urothelial
carcinoma under experimental conditions.