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Radiation nephropathy
Other Resources UpToDate PubMed

Radiation nephropathy

Contributors: Casey Silver MD, Catherine Moore MD, Michael W. Winter MD
Other Resources UpToDate PubMed


Radiation nephropathy is characterized by kidney dysfunction following external radiation with no histologic evidence of inflammation.

Clinical presentations include:
  • Acute nephropathy – Abrupt onset after a 6- to 12-month latent period following radiation exposure.
  • Chronic nephropathy – May follow an acute episode or may follow a more indolent course, presenting more than 12 months after radiation exposure.
  • Benign or malignant hypertension – May occur from 18 months to years after radiation exposure.
  • Asymptomatic proteinuria – Frequently intermittent, this may be the only sign.
Common signs and symptoms are severe anemia, hypertension, and increased serum creatinine. Symptoms may also include microscopic hematuria and edema.


N14.4 – Toxic nephropathy, not elsewhere classified
T66.XXXA – Radiation sickness, unspecified, initial encounter

236514003 – Toxic nephropathy

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Differential Diagnosis & Pitfalls

In bone-marrow transplant patients who develop Chronic kidney disease, consider:
  • Cyclosporine or tacrolimus toxicity
  • Pamidronate-induced Focal segmental glomerulosclerosis
  • Nephrotic syndrome associated with Chronic graft-versus-host disease
  • Polyomavirus nephropathy
Differential diagnosis also includes:
  • Chronic kidney disease – broad differential, including hypertension-induced, vasculitis-associated, heart failure or cirrhosis-related (Cardiorenal syndrome or Hepatorenal syndrome)
  • Hemolytic uremic syndrome
  • Acute tubular necrosis
  • Acute interstitial nephritis
  • Pre-renal azotemia

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Last Reviewed:04/11/2019
Last Updated:05/07/2019
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Radiation nephropathy
A medical illustration showing key findings of Radiation nephropathy : Fatigue, Creatinine elevated, Edema, Hyperkalemia, Proteinuria, Dyspnea, BP increased
Copyright © 2024 VisualDx®. All rights reserved.