Balkan endemic nephropathy (BEN) is a serious kidney disease that occurs only in clusters of rural villages located in tributary valleys of the Danube River in the Balkan Peninsula. This U.S. Geological Survey found that at least 25,000 persons are suffering from BEN or are suspected of having the disease and that the total number of people at risk may exceed 100,000. BEN was first described as a distinct medical entity in 1956, but it may have existed unreported for many centuries. The geographic distribution of the disease has not changed significantly since the 1950s. Villages afflicted in the past continue to have cases of BEN, while villages with no history of BEN (some of which are only a few miles from affected villages) have remained free of this disease.
The principal difference is that the former has water wells in an aquifer with lignite, the latter does not. The groundwater supplies from water wells located in the lignite belts of Texas and Louisiana, and of those in Nebraska and elsewhere may be vulnerable.
For additional clinical information on BEN, see:
http://www.uptodate.com/contents/balkan-endemic-nephropathy
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