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More broadly, we think that aristolochic acid nephropathy and urothelial cell carcinoma represent a long-overlooked global disease and an international public health problem of significant magnitude. Dr. Grollman and colleagues explain extracting DNA from tumors of 67 UUC patients surviving in a region recognized to harbor endemic nephropathy. They detected a metabolite of aristolochic acid bound to DNA -DNA adducts) in the kidney cortex of the patients. Regarding to Dr. Grollman, these adducts, formed by the result of aristolochic DNA and acid, trigger alterations in the properties of genomic DNA.