Renal and Genito-Urinary
Kidney and Radiation Therapy (RT)
The kidneys are very sensitive to RT and radiation induced nephritis is a significant risk when treating areas such as the TL spine or the retroperitoneum.
RT induced nephritis (also called nephropathy) usually occurs after a latent period of 3–
12 months.
Clinical features:
- Hypertension
- Proteinuria
- Renal insufficiency
- Anemia
Doses less than 18 Gy to the whole kidney appear to rarely cause severe or long-lasting
renal injury.
Doses greater than 20 Gy result in significant nephropathy.
Cohen and Robbins have provided a recent summary of the pathogenesis of this disorder and its treatment with angiotensin converting enzyme inhibitors or angiotensin II receptor
blockers.
Most radiation nephropathy late effects studies have been done in children with Wilms tumor. In general, studies have shown that the risk for renal insufficiency is higher among children receiving higher doses of RT.
In a cohort of children evaluated 5 years after receiving abdominal radiation for Wilms tumor, 7% had hypertension.
