Early effects of radiation on renal function in man

Avioli, Louis V.; Lazor, Michael Z.; Cotlove, Ernest; Brace, Kirkland C.; Andrews, J.Robert

doi:10.1016/0002-9343(63)90120-7

Cited by 74 publications

(15 citation statements)

References 19 publications

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“…There is, however, a lack of dynamic studies evaluating a possible renal injury. Avioli et al (1963) assessed the acute effect of radiotherapy on the renal function in ten patients. They found that the most significant effect was on the renal plasma flow which fell progressively during the treatment period beginning at 4 Gy.…”

Section: Cmentioning

confidence: 99%

Renal function related to different treatment modalities for malignant germ cell tumours

Aass

Fosså²,

Aas³

et al. 1990

Br J Cancer

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Summary The renal function was evaluated with '3'I-Hippuran clearance in 171 patients with malignant germ cell tumours. Assessments were performed before treatment and at three fixed times afterwards within 5 years. The patients were treated with surgery only (20 patients), infra-diaphragmatic radiotherapy only (median midplane dose 36 Gy) (48 patients), cisplatin-based chemotherapy (total cisplatin dose 500-850 mg) plus surgery (64 patients), cisplatin-based chemotherapy (total cisplatin dose> 850 mg) with or without surgery (23 patients) or cisplatin-based chemotherapy (total cisplatin dose 500-850mg) plus infra-diaphragmatic radiotherapy (16 patients). No renal impairment was observed for patients treated with surgery only. In patients who received radiotherapy no change of the renal function occurred during the first year post-treatment. Three to five years after treatment discontinuation a statistically significant reduction within the normal range was observed in patients who were >40 years at the time of irradiation. Cisplatin-based chemotherapy led to a statistically significant irreversible renal impairment for all the three groups. The greatest reduction was seen in patients who received the highest total cisplatin dose or who were treated with irradiation in addition to chemotherapy. The clinical significance of the observed nephrotoxicity is still unknown.There is a lack of comparative studies regarding nephrotoxicity after different treatment modalities for testicular cancer. Renal toxicity is a well-known side effect after cisplatin-based combination chemotherapy (Dentino et al., 1978;Offerman et al., 1984;Safirstein et al., 1986), but less attention has been paid to the possible renal impairment after high-voltage abdominal radiotherapy and the combination of chemotherapy and irradiation.The aim of the present prospective study was to evaluate the renal function after retroperitoneal lymph node dissection, cisplatin-based chemotherapy, abdominal radiotherapy, and after combined treatment with chemotherapy and irradiation. Both the acute and the long-term results were assessed. Patients and methodsA total of 171 patients with malignant germ cell tumours (testicular 162, extragonadal nine) were included in the study (Table I). These patients represented a consecutive series of patients treated at The Norwegian Radium Hospital during two periods

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Section: Cmentioning

confidence: 99%

Renal function related to different treatment modalities for malignant germ cell tumours

Aass

Fosså²,

Aas³

et al. 1990

Br J Cancer

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“…In radiation nephropathy, renal endothelial dysfunction and altered hemodynamics are known features [20–22]. Inflammation is not prominent, but tubular cell loss and progressive interstitial scarring coincide with progressive loss of renal function [23].…”

Section: Introductionmentioning

confidence: 99%

Epoxyeicosatrienoic acid analogue mitigates kidney injury in a rat model of radiation nephropathy

et al. 2016

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Arachidonic acid is metabolized to epoxyeicosatrienoic acids (EETs) by CYP-epoxygenases, and EETs are kidney protective in multiple pathologies. We determined the ability of an EET analog, EET-A, to mitigate experimental radiation nephropathy. The kidney expression of the EET producing enzyme CYP2C11 was lower in rats that received total body irradiation (TBI rat) compared to non-irradiated control. At 12 weeks after TBI, the rats had higher systolic blood pressure and impaired renal afferent arteriolar function compared to control, and EET-A or captopril mitigated these abnormalities. The TBI rats had 3-fold higher blood urea nitrogen compared to control, and EET-A or captopril decreased BUN by 40–60%. The urine albumin/creatinine ratio was increased 94-fold in TBI rats, and EET-A or captopril attenuated that increase by 60–90%. In TBI rats, nephrinuria was elevated 30-fold and EET-A or captopril decreased it by 50–90%. Renal interstitial fibrosis, tubular, and glomerular injury were present in the TBI rats, and each was decreased by EET-A or captopril. We further demonstrated elevated renal parenchymal apoptosis in TBI rats, which EET-A or captopril mitigated. Additional studies revealed that captopril or EET-A mitigated renal apoptosis by acting on p53/Fas/FasL apoptotic pathway. Overall, this study demonstrates a novel EET-analog based strategy for mitigation of experimental radiation nephropathy by improving renal afferent arteriolar function and by decreasing renal apoptosis.

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“…However, a portion of the patients, particularly those without renal shielding, suffered a declining quality of life attributable to the renal dysfunction after TBI/BMT. Morever, when more sensitive indicators were used for the definition of renal dysfunction, i.e., [ 51 Cr] EDTA clearance, renal plasma flow, or glomerular filtration rate, most patients and animals presented some signs of radiation-induced renal damage [1,15,16]. Accordingly, we might have detected long-latent severe renal damages by a longer follow-up.…”

Section: Discussionmentioning

confidence: 99%