Because of fear of malignancies, the Belgian researchers who first described the condition have advocated prophylactic removal of the kidneys and ureters in patients with Chinese herb nephropathy. Of 39 patients who agreed to this, 18 (46%) had urothelial carcinoma, 19 of the others had mild to moderate urothelial dysplasia, and only two had normal urothelium (Nortier et al., 2000). All tissue samples contained aristolochic acid-related DNA in adducts. The original dose of Aristolochia correlated positively with the risk of urothelial carcinoma.
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