Radiation-Induced Chronic Kidney Disease

Radiation Nephropathy (or Arteriolar Nephrosclerosis) is damage to both kidneys with loss of function as a result of ionizing radiation. Ionizing radiation of sufficient energy disrupts chemical bonds and cause DNA-injury within milliseconds of irradiation.

The occurrence of renal dysfunction as a consequence of ionizing radiation has been known for more than 100 years[1].

The threshold dose for radiation nephropathy was identified as 23 Gy from radiation of both kidneys when given in 20 fractions over 4 weeks[2]. Lower radiation doses may cause kidney injury after many years of follow-up. Thus, in survivors of the Hiroshima and Nagasaki atomic bombs, estimated single fraction exposure of 2 Gy were associated with Chronic Kidney Disease (CKD) and the development of Cardiovascular Disease (CVD) among A-bomb survivors after many decades[3][4].

[Hiroshima: after the atomic bomb]

Radiation also had a therapeutic use for cancers like Hodgkin lymphoma and non-Hodgkin lymphoma. Now, other therapies have been developed and incidences of Radiation Nephropathy have subsequently declined[5].

Signs and symptoms are indistinguishable from renal failure from any other cause.

I propose to call this Chronic Kidney Disease of non-Traditional causes (CKDnT): Radiation-Induced Chronic Kidney Disease.

[1] Bärmann, Linser: Ueber die lokale und allgemeine Wirkung der Röntgenstrahlen in Münchener medizinische Wochenschrift - 1904
[2] Luxton: Radiation nephritis: A long term study of 54 patients in Lancet - 1961
[3] Sera et al: The association between chronic kidney disease and cardiovascular risk factors in atomic bomb survivors in Radiation Research – 2013
[4] Adams et al: Radiation Dose Associated with Renal Failure Mortality: A Potential Pathway to Partially Explain Increased Cardiovascular Disease Mortality Observed after Whole-Body Irradiation in Radiation Research – 2012
[5] Jairam et al: Historical trends in the use of radiation therapy for pediatric cancers: 1973-2008 in International Journal for Radiation Oncology, Biology and Physics