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

Journal Article · Mon Oct 01 00:00:00 EDT 1990 · International Journal of Radiation Oncology, Biology and Physics; (USA)

DOI:https://doi.org/10.1016/0360-3016(90)90022-C· OSTI ID:6214828

Dewit, L; Anninga, J K; Hoefnagel, C A; Nooijen, W J ^[1]

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1. Netherlands Cancer Institute, Antoni van Leeuwenhoek Huis, Amsterdam (Netherlands)

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.

• OSTI ID: 6214828
• Journal Information: International Journal of Radiation Oncology, Biology and Physics; (USA), Vol. 19:4; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

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
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