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Title: Radiation injury in the human kidney: A prospective analysis using specific scintigraphic and biochemical endpoints

Abstract

Renal function was prospectively analyzed in 26 evaluable patients, irradiated to various doses on their kidneys for neoplastic disease. Glomerular function was assessed by 99mTc-DTPA renography, creatinine clearance, and serum beta 2-microglobulin, whereas tubular function was monitored by 99mTc-DMSA scintigraphy, urine beta 2-microglobulin, urine N-acetyl glucosaminidase, and alanine aminopeptidase and a urine concentration test. In the patients given the highest irradiation dose to the entire left kidney, that is, 40 Gy in 5 1/2 weeks, glomerular and tubular functional impairment, as assessed scintigraphically, progressed at a rate of 2.0 +/- 1.0% (+/- 1 SD) and 2.0 +/- 0.5% per month, respectively, down to 30-40% after 3 to 5 years. The overall glomerular function, as assessed by creatinine clearance, decreased by only 20%. In the patients irradiated unilaterally on the upper pole to 40 Gy in 4 weeks, glomerular and tubular function in the left kidney deteriorated at 0.75 +/- 0.33% and 0.75 +/- 0.20% per month in the first 2 years, down to 75-80% at 5 years. This smaller reduction was due to shielding of a part of the left kidney. No changes were observed, thus far, after bilateral whole kidney irradiation to 17-18 Gy in 3 1/2 weeks. Themore » concentration capacity of the kidney after total volume irradiation was not impaired. There was a trend for an increase in diastolic blood pressure in 3 out of 5 patients given the high dose irradiation to the entire left kidney and in 2 out of 7 patients irradiated on the upper pole of the left kidney. The progressive nature of the radiation nephropathy stresses the need for long term follow-up to determine more accurately the tolerance dose of the human kidney for irradiation.« less

Authors:
; ; ;  [1]
  1. Netherlands Cancer Institute, Antoni van Leeuwenhoek Huis, Amsterdam (Netherlands)
Publication Date:
OSTI Identifier:
6214828
Resource Type:
Journal Article
Journal Name:
International Journal of Radiation Oncology, Biology and Physics; (USA)
Additional Journal Information:
Journal Volume: 19:4; Journal ID: ISSN 0360-3016
Country of Publication:
United States
Language:
English
Subject:
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.; 62 RADIOLOGY AND NUCLEAR MEDICINE; KIDNEYS; BIOLOGICAL RADIATION EFFECTS; NEOPLASMS; RADIOTHERAPY; SIDE EFFECTS; UROGENITAL SYSTEM DISEASES; RADIOINDUCTION; BLOOD PRESSURE; CREATININE; DTPA; DYNAMIC FUNCTION STUDIES; ISOMERIC NUCLEI; PATIENTS; RADIATION DOSES; SCINTISCANNING; TECHNETIUM 99; AMINO ACIDS; AZOLES; BETA DECAY RADIOISOTOPES; BETA-MINUS DECAY RADIOISOTOPES; BIOLOGICAL EFFECTS; BODY; CARBOXYLIC ACIDS; CHELATING AGENTS; COUNTING TECHNIQUES; DIAGNOSTIC TECHNIQUES; DISEASES; DOSES; DRUGS; HETEROCYCLIC COMPOUNDS; HOURS LIVING RADIOISOTOPES; IMIDAZOLES; IMINES; INTERMEDIATE MASS NUCLEI; ISOMERIC TRANSITION ISOTOPES; ISOTOPES; MEDICINE; NUCLEAR MEDICINE; NUCLEI; ODD-EVEN NUCLEI; ORGANIC ACIDS; ORGANIC COMPOUNDS; ORGANIC NITROGEN COMPOUNDS; ORGANS; RADIATION EFFECTS; RADIOISOTOPE SCANNING; RADIOISOTOPES; RADIOLOGY; RADIOPROTECTIVE SUBSTANCES; TECHNETIUM ISOTOPES; THERAPY; YEARS LIVING RADIOISOTOPES; 560151* - Radiation Effects on Animals- Man; 550601 - Medicine- Unsealed Radionuclides in Diagnostics

Citation Formats

Dewit, L, Anninga, J K, Hoefnagel, C A, and Nooijen, W J. Radiation injury in the human kidney: A prospective analysis using specific scintigraphic and biochemical endpoints. United States: N. p., 1990. Web. doi:10.1016/0360-3016(90)90022-C.
Dewit, L, Anninga, J K, Hoefnagel, C A, & Nooijen, W J. Radiation injury in the human kidney: A prospective analysis using specific scintigraphic and biochemical endpoints. United States. https://doi.org/10.1016/0360-3016(90)90022-C
Dewit, L, Anninga, J K, Hoefnagel, C A, and Nooijen, W J. 1990. "Radiation injury in the human kidney: A prospective analysis using specific scintigraphic and biochemical endpoints". United States. https://doi.org/10.1016/0360-3016(90)90022-C.
@article{osti_6214828,
title = {Radiation injury in the human kidney: A prospective analysis using specific scintigraphic and biochemical endpoints},
author = {Dewit, L and Anninga, J K and Hoefnagel, C A and Nooijen, W J},
abstractNote = {Renal function was prospectively analyzed in 26 evaluable patients, irradiated to various doses on their kidneys for neoplastic disease. Glomerular function was assessed by 99mTc-DTPA renography, creatinine clearance, and serum beta 2-microglobulin, whereas tubular function was monitored by 99mTc-DMSA scintigraphy, urine beta 2-microglobulin, urine N-acetyl glucosaminidase, and alanine aminopeptidase and a urine concentration test. In the patients given the highest irradiation dose to the entire left kidney, that is, 40 Gy in 5 1/2 weeks, glomerular and tubular functional impairment, as assessed scintigraphically, progressed at a rate of 2.0 +/- 1.0% (+/- 1 SD) and 2.0 +/- 0.5% per month, respectively, down to 30-40% after 3 to 5 years. The overall glomerular function, as assessed by creatinine clearance, decreased by only 20%. In the patients irradiated unilaterally on the upper pole to 40 Gy in 4 weeks, glomerular and tubular function in the left kidney deteriorated at 0.75 +/- 0.33% and 0.75 +/- 0.20% per month in the first 2 years, down to 75-80% at 5 years. This smaller reduction was due to shielding of a part of the left kidney. No changes were observed, thus far, after bilateral whole kidney irradiation to 17-18 Gy in 3 1/2 weeks. The concentration capacity of the kidney after total volume irradiation was not impaired. There was a trend for an increase in diastolic blood pressure in 3 out of 5 patients given the high dose irradiation to the entire left kidney and in 2 out of 7 patients irradiated on the upper pole of the left kidney. The progressive nature of the radiation nephropathy stresses the need for long term follow-up to determine more accurately the tolerance dose of the human kidney for irradiation.},
doi = {10.1016/0360-3016(90)90022-C},
url = {https://www.osti.gov/biblio/6214828}, journal = {International Journal of Radiation Oncology, Biology and Physics; (USA)},
issn = {0360-3016},
number = ,
volume = 19:4,
place = {United States},
year = {Mon Oct 01 00:00:00 EDT 1990},
month = {Mon Oct 01 00:00:00 EDT 1990}
}