Unilateral radiation nephropathy--the long-term significance.
Eighteen patients with gastrointestinal and retroperitoneal non-Hodgkin's lymphoma received abdominal radiotherapy as their primary treatment. Each patient received a total tumor dose of 2200 to 4500 cGy in 5 to 9 weeks to the whole or half of one kidney. Nine patients developed unilateral radiation nephropathy demonstrable on post-treatment evaluation with 99m Tc glucoheptonate blood flow, delayed static scan, and an I-131 radio-hippurate renal perfusion study. The tests were periodically repeated over periods ranging from 5 to 8 years. Six patients with nephropathy and 4 patients without nephropathy were followed 5 years or longer. The minimum nephro-pathogenic irradiation dose was 2200 cGy delivered in 59 days. The incidence of nephropathy is higher with increase in the total dose. Short term recovery in function was observed in 3 patients and long-term complete recovery was observed in one patient. Atrophic renal change was irreversible and progressive in 3 patients over a 6 to 7 year follow-up period. In this group of patients, an abnormal creatinine clearance and serum beta-2 microglobulin level was indicative of vascular damage. Elevated arterial blood pressure was seen in 5 patients. All were controlled medically, without nephrectomy. There was no other clinically significant problem resulting from the unilateral nephropathy in this group of patients.
D005500:Follow-Up Studies; D005770:Gastrointestinal Neoplasms / Q000532:radiotherapy; D006801:Humans; D007465:Iodohippuric Acid; D007668:Kidney / Q000528:radiation effects*; D007674:Kidney Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008223:Lymphoma / Q000532:radiotherapy; D015609:Organotechnetium Compounds; D011877:Radionuclide Imaging; D011882:Radiotherapy, High-Energy / Q000009:adverse effects*; D012186:Retroperitoneal Neoplasms / Q000532:radiotherapy; D013400:Sugar Acids; D013667:Technetium
D015609:Organotechnetium Compounds; D013400:Sugar Acids; D007465:Iodohippuric Acid; D013667:Technetium; C100014:technetium Tc 99m gluceptate