RADIATION NEPHRITIS: A Long-term Study of 54 Patients

Abstract

S>Radiation nephritis may result when the kidneys are included in therapeutic fields of deep x rays. In 54 patients observed over 13 yr, initial clinical presentations were acute radiation nephritis (20 cases), primary chronic radiation nephritis (10), benign hypertension (8), late malignant hyfentension (5), and proteinuria (13). In acute radiation nephritis the immediate prognosis was related to the occurrence of malignant hypertension from which spontaneous recovery followed in 2 patients. After recovery from the acute phase, chronic nephritis always remained. Chronic radiation nephritis may develop insidiousiy (primary chronic radiation nephritis) or it may follow acute radiation nephritis (secondary chronic radiation nephritis). The ultimate prognosis may be better in the secondary type. Of 6 patients with benign hypentension syndrome, 2 died of congestive heart failure and 1 of malignant hypentension. Proteinuria alone, after renal irradiation, may denote a latent form of nephritis. Of the 54 patients, 15 (28%) developed malignant hypentension sooner or later. Thus the study supports the concept obtained from animal experiments that x irradiation of the kidneys has 2 distinct and independent biological effects: hypertension and interstitial fibrosis. (H.H.D.)