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.
• 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.