Radiation nephropathy

Dose, management, and population risk

Cohen, Eric P
Premuzic, Tihana
Cohen, Alexander P

¹Division of Nephrology, New York University School of Medicine, New York, NY, USA
²Division of Nephrology, University of Maryland School of Medicine, Baltimore, MD, USA
³Office of Chief Medical Examiner, City of New York, Brooklyn, NY, USA

Eric P Cohen, Division of Nephrology, New York University School of Medicine, Manhattan VAMC, 423 East 23rd Street, New York, NY 10010, USA. Email: [email protected]

Received September 24, 2021

Accepted November 8, 2021

Journal of Onco-Nephrology 6(1-2):p 23-28, June 2022. | DOI: 10.1177/23993693211064065

Radiation nephropathy is renal injury caused by a sufficient dose of irradiation. It can result from external beam irradiation or internal irradiation as might occur from therapeutic radioisotopes. Its usual clinical presentation is as chronic kidney disease occurring some months after irradiation, and it can evolve to end-stage-renal-disease. While the immediate cellular injury from irradiation depends on radiolysis of water and oxidative DNA damage, there is no conclusive evidence for chronic persistent oxidative stress or inflammation as the cause of the multi-tissue scarring that ensues. Antagonists of the renin-angiotensin system are effective treatments for experimental radiation nephropathy but their preferential value in human clinical medicine is unproven.