Radiation nephritis

• What is Radiation Nephritis
• Statistics on Radiation Nephritis
• Risk Factors for Radiation Nephritis
• Progression of Radiation Nephritis
• Symptoms of Radiation Nephritis
• Clinical Examination of Radiation Nephritis
• How is Radiation Nephritis Diagnosed?
• Prognosis of Radiation Nephritis
• How is Radiation Nephritis Treated?
• Radiation Nephritis References

What is Radiation Nephritis

Radiation nephritis (Rad Np) is kidney injury and impairment of function caused by ionizing radiation. It may occur after irradiation of one or both kidneys, and it may result in kidney failure.

Statistics on Radiation Nephritis

This condition has almost disappeared from clinical presentation with better understanding of its aetiology by radiologists.

Risk Factors for Radiation Nephritis

Exposure to a radioactive source strong enough for a long period of time may result in the development of radiation nephritis. Without exposure to radiation, the condition cannot occur.

Progression of Radiation Nephritis

Acute radiation nephritis is an acute process that occurs 6-12 months after the initial radiation insult. As mentioned above, the renal vessels are thought to be primarily responsible for the pathological changes of the kidney. As the blood vessels are damaged, the kidney tissues recieve less blood, and less oxygen to perform normal processes. As a result, they may die or atrophy (shrink) to compensate. This leads to reduced renal function, allowing 50% of patients who suffer acute radiation nephritis to progress into chronic renal failure. This process may occur slowly over many years.

How is Radiation Nephritis Diagnosed?

Several blood tests and urine samples will be collected to assess the patient’s renal function and other effects that this condition has upon the body. The results of these tests will allow doctors to tailor treatment and provide the patient with a prognosis for their condition. An ultrasound may be required to exclude a urinary tract obstruction.

Prognosis of Radiation Nephritis

Chronic renal failure will occur in 50% of patients suffering from acute radiation nephritis. Malignant hypertension may also be a continuing problem following radiation nephritis.

How is Radiation Nephritis Treated?

Management of this condition is not unlike the management of other forms of nephritis. The primary aim to minimise the deterioration of renal function. Management of high blood pressure and dietary salt restriction will slow the development of renal failure. The use of corticosteroid therapy will also benefit patients suffering radiation nephritis.

Radiation Nephritis References

[1] Braunwald, Fauci, Kasper, Hauser, Longo, Jameson. Harrison’s Principles of Internal Medicine. 15th Edition. McGraw-Hill. 2001.
[2] Kumar P, Clark M. CLINICAL MEDICINE. WB Saunders 2002 Pg 545-549.
[3] Moulder JE, Fish BL, Cohen EP. Radiation nephropathy is treatable with an angiotensin converting enzyme inhibitor or an angiotensin II type-1 (AT1) receptor antagonist. Radiother Oncol. 1998 Mar;46(3):307-15.