ACUTE RADIATION NEPHRITIS

Journal Article · Sat Dec 01 04:00:00 EST 1962 · California Medicine (U.S.) Changed to West. J. Med.

OSTI ID:4715147

Baldwin, J N; Hagstrom, J W.C.

S>Acute nephritis resulting from x-ray therapy of a nonresectable abdominal lymphosarcoma in a 63-yr-old man is reported. The estimated dose to each kidney was 3960 r, given over a period of 39 days. Symptoms of renal failure appeared 7 months later. The clinical features included hypertension, albuminuria, anemia, azotemia, congestive heart failure, and edema. These symptoms stem from a failure of 3 interrelated systems: renal, hematopoietic, and cardiac. Deterioration of kidney function probably occurs first, with consequent loss of concentrating power, nitrogen retention, and albuminuria. Oliguria is a terminal event, and death usually occurs within 3 or 4 months of the appearance of symptoms. The anemia of acute radiation nephritis is severe, rapid, refractory, and normocyticnormochromic. The marrow is not aplastic. Cardiac failure is often the presenting symptoms of acute radiation nephritis. Hypertension is striking and is assumed to be secondary to renal damage. Four structures are severely affected by renal irradiation: interstitium, glomeruli, tubules, and arterioles. Most consistently there is fibrosis of the interstitium, and, in time, contraction of the scar tissue leads to interference with glomerular and tubular blood supply. The glomeruli may be atrophied, have endothelial proliferation, or show partial or complete fibrosis. Tubules may undergo necrosis and atrophy. Arteriolar walls are often thickened and many show intimal endothelial proliferation. Care of the patient in any of the phases of nephritis can only be supportive and symptomatic, as there is no evidence to indicate that the lesions will regress. In the case reported, a brief trial of corticosteroids had no effect. (H.H.D.)

• Research Organization: Univ. of California, San Francisco
• NSA Number: NSA-17-027203
• OSTI ID: 4715147
• Journal Information: California Medicine (U.S.) Changed to West. J. Med., Journal Name: California Medicine (U.S.) Changed to West. J. Med. Vol. Vol: 7; ISSN CAMEA
• Country of Publication: Country unknown/Code not available
• Language: English

Related Subjects

AGE
ANEMIA
BIOLOGY AND MEDICINE
BLOOD CIRCULATION
BLOOD FORMATION
BLOOD VESSELS
CANCER
CYTOLOGY
HEART
KIDNEYS
LYMPH SYSTEM
LYMPHOSARCOMAS
MAN
MEDICINE
NEPHRITIS
QUANTITY RATIO
RADIATION DOSES
RADIATION INJURIES
RADIOTHERAPY
TUMORS
URINE