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Prominent plants, is a powerful nephrotoxin and human carcinogen associated with chronic kidney disease (CKD) and upper urinary tract urothelial carcinomas (UUC) (1).These dual toxicities and target tissues were revealed when a group of otherwise healthy Belgian women developed renal failure and UUC after ingesting herbs in conjunction with a weight-loss regime (2, 3).Reports of this syndrome, now known as aristolochic acid nephropathy (AAN), called attention to the serious toxicities associated with the use of sp. Subsequently, sporadic cases of AAN were reported in countries throughout the world (4, 5).AA was shown recently to be the causative agent of Balkan endemic nephropathy (EN) (6, 7).

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Importantly, 43% of these carcinomas were located in the upper urinary tract (13).

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plants, is associated with urothelial carcinoma of the upper urinary tract (UUC).

This devastating environmental disease, affecting residents of rural farming villages in Bosnia and Herzegovina, Bulgaria, Croatia, Romania, and Serbia, is associated with a high incidence of UUC (8, 9).

In EN, exposure to AA occurs via consumption of bread prepared from flour contaminated with seeds of (10).

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