Radiation nephropathy
Alerts and Notices
Synopsis
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.
Codes
ICD10CM:N14.4 – Toxic nephropathy, not elsewhere classified
T66.XXXA – Radiation sickness, unspecified, initial encounter
SNOMEDCT:
236514003 – Toxic nephropathy
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Diagnostic Pearls
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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 glomerulosclerosis
- Nephrotic syndrome associated with graft-versus-host disease
- Polyomavirus nephropathy
- Chronic kidney disease – broad differential, including hypertension-induced, vasculitis-associated, heart failure or cirrhosis-related (cardiorenal or hepatorenal syndrome)
- Hemolytic-uremic syndrome
- Acute tubular necrosis
- Acute interstitial nephritis
- Pre-renal azotemia
Best Tests
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Management Pearls
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Therapy
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References
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Last Reviewed:04/11/2019
Last Updated:05/07/2019
Last Updated:05/07/2019