title: Radiation-associated kidney injury.
abstract: The kidneys are the dose-limiting organs for radiotherapy to upper abdominal cancers and during total body irradiation. The incidence of radiotherapy-associated kidney injury is likely underreported owing to its long latency and because the toxicity is often attributed to more common causes of kidney injury. The pathophysiology of radiation injury is poorly understood. Its presentation can be acute and irreversible or subtle, with a gradual progressive dysfunction over years. A variety of dose and volume parameters have been associated with renal toxicity and are reviewed to provide treatment guidelines. The available predictive models are suboptimal and require validation. Mitigation of radiation nephropathy with angiotensin-converting enzyme inhibitors and other compounds has been shown in animal models and, more recently, in patients.
authors.affiliation: Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, Ontario, Canada. laura.dawson@rmp.uhn.on.ca
authors.forename: Laura A
authors.initials: LA
authors.lastname: Dawson
authors.forename: Brian D
authors.initials: BD
authors.lastname: Kavanagh
authors.forename: Arnold C
authors.initials: AC
authors.lastname: Paulino
authors.forename: Shiva K
authors.initials: SK
authors.lastname: Das
authors.forename: Moyed
authors.initials: M
authors.lastname: Miften
authors.forename: X Allen
authors.initials: XA
authors.lastname: Li
authors.forename: Charlie
authors.initials: C
authors.lastname: Pan
authors.forename: Randall K
authors.initials: RK
authors.lastname: Ten Haken
authors.forename: Timothy E
authors.initials: TE
authors.lastname: Schultheiss
mesh_terms: D000818:Animals; D004307:Dose-Response Relationship, Radiation; D005544:Forecasting; D006801:Humans; D007668:Kidney / Q000528:radiation effects*; D023421:Models, Animal; D011832:Radiation Injuries / Q000150:complications* / Q000503:physiopathology; D011836:Radiation Tolerance; D014916:Whole-Body Irradiation / Q000009:adverse effects