Presentation
In the present case, Tc-99m MDP, Tl-201 and Tc-99m MAG3 findings may provide useful information for understanding pathophysiological damage in the kidney after radiation. [ncbi.nlm.nih.gov]
A detailed presentation of the patient’s clinical course (blood pressure, serum and urine chemistries) will be presented, along with a review of the current literature on the pathophysiology and management of radiation nephritis. [archive.rubicon-foundation.org]
Entire Body System
- Fishing
WB Saunders 2002 Pg 545-549. [3] Moulder JE, Fish BL, Cohen EP. Radiation nephropathy is treatable with an angiotensin converting enzyme inhibitor or an angiotensin II type-1 (AT1) receptor antagonist. Radiother Oncol. 1998 Mar;46(3):307-15. [myvmc.com]
Int J Radiat Oncol Biol Phys 17: 433–436 PubMed CrossRef Google Scholar Moulder JE, Fish BL (1991) Influence of nephrotoxic drugs on the late renal toxicity associated with bone marrow transplant conditioning regimens. [link.springer.com]
Psychiatrical
- Suggestibility
This case and similar previous reports suggest a potentiating effect by the chemotherapy of the renal damage by radiation which may cause radiation nephritis to develop at radiation doses normally within renal tolerance. [ncbi.nlm.nih.gov]
Followup: MRI examination performed six months after this study and the course of radiation demonstrated no new focal lesions to suggest metastatic disease. Also, the epidural mass extending from L2 - L4 and the pedicles of L3 remained unchanged. [gamma.wustl.edu]
While we may not be able to respond to every message, we appreciate your comments and suggestions. (Comments are now closed.) Advertisement Advertisement [archive.archaeology.org]
Workup
At the time of hyperbaric consultation, the patient had been admitted to the pediatric intensive care unit for workup and management of uncontrollable hypertension and worsening renal function. [archive.rubicon-foundation.org]
QT, RR, ST Intervals
- ST Elevation
Note the ST elevation in multiple leads with slight reciprocal ST depression in aVR. ICD 10 I … Wikipedia Nephrology — the article on the kidney for the anatomy and function of healthy kidneys and a list of diseases involving the kidney. [medicine.academic.ru]
Other Pathologies
- Fibrinoid Necrosis
By light microscopy the changes were of fibrinoid necrosis of the arteries and atrerioles with segmental necrosis of the glomerular tufts. [ncbi.nlm.nih.gov]
[…] and atrophy; often abnormal tubular regeneration; focally scarred interstitium without inflammation Vessels: fibrinoid necrosis of arterioles and small arteries with variable thrombosis Microscopic (histologic) images Images hosted on other servers: [pathologyoutlines.com]
Treatment
Chronic radiation nephritis: this may occur after acute radiation nephritis; alternatively chronic radiation nephritis may present with hypertension, anaemia, proteinuria or end-stage renal failure 2-5 years after radiotherapy treatment Treatment: treatment [gpnotebook.co.uk]
After consultation with the patient and mother, informed consent (parent) and assent (child) were obtained for HBO2 treatment. The patient received 32 treatments (2.5 ATA x 90 minutes) over a 59-day time period. [archive.rubicon-foundation.org]
A 34-year-old woman presented with acute radiation nephritis three months after completion of treatment with cytotoxic chemotherapy and abdominal radiotherapy. [ncbi.nlm.nih.gov]
Prognosis
The results of these tests will allow doctors to tailor treatment and provide the patient with a prognosis for their condition. An ultrasound may be required to exclude a urinary tract obstruction. [myvmc.com]
Prognosis Radiation nephropathy may progress to end-stage renal failure. [emedicine.medscape.com]
There is no clear evidence that corticosteroids help. [6] Nutrition therapy consists of adequate fluid intake, which can require several liters of extra fluid. [21] Prognosis [ edit ] The kidneys are the only body system that are directly affected by [en.wikipedia.org]
• Favourable prognosis. 66. [slideshare.net]
Prognosis: Rapid progression to ESRD (6 months -- 2 years) CLINICAL PEARL: High prevalence of Urothelial Malignancies (40-50%) of: Upper urinary tract ( multifocal high-grade transitional cell carcinoma) and bladder ** Most commonly detected in pts with [renalandurologynews.com]
Etiology
Therefore, in this patient with a history of recent radiation treatments, radiation nephritis is the most likely etiology. [gamma.wustl.edu]
Etiology Radiation nephropathy is due to cellular injury caused by ionizing radiation. [emedicine.medscape.com]
[…] are most common etiological agents. 53. [slideshare.net]
[…] only a small proportion of patients Renal biopsy - granulomatous inflammatory infiltrate is confined to the cortex (versus drug-induced interstitial nephritis, predilection for corticomedullary junction ( Figure 2 ) Need to consider other potential etiologies [renalandurologynews.com]
Epidemiology
The circumstances of human exposures (therapeutic, accidental, warfare) are then considered in the light of extensive epidemiological data. [books.google.de]
Epidemiology [ edit ] Interstitial nephritis is uncommon ( acute kidney injury of unknown cause. [2] While it can occur in patients of all ages, it is more common in elderly patients, perhaps due to increased exposure to drugs and other triggering causes [en.wikipedia.org]
[…] effect of radiation dose to the kidneys was also different among nephrectomized patients for whom any exposure to radiation was associated with an elevated risk of chronic kidney disease even at doses less than 5 Gy.Furthermore, data from the renal epidemiology [theses.fr]
Epidemiology Clinical radiation nephropathy, and its congener, the BMT nephropathy syndrome, have been reported worldwide. Radiation nephropathy does not occur in all irradiated patients. [emedicine.medscape.com]
"Lead-related nephrotoxicity: A review of the epidemiologic evidence". Kidney International. vol. 70. 2006. pp. 2074-2084. Evans, M, Elinder, C-G. "Chronic renal failure from lead: myth or evidence-based fact". [renalandurologynews.com]
Pathophysiology
In the present case, Tc-99m MDP, Tl-201 and Tc-99m MAG3 findings may provide useful information for understanding pathophysiological damage in the kidney after radiation. [ncbi.nlm.nih.gov]
A detailed presentation of the patient’s clinical course (blood pressure, serum and urine chemistries) will be presented, along with a review of the current literature on the pathophysiology and management of radiation nephritis. [archive.rubicon-foundation.org]
Pathophysiology Oxidative injury to the deoxyribonucleic acid (DNA) initiates injury to healthy tissue by ionizing radiation. This is a genotoxic injury. A cell with sufficient DNA injury eventually dies after several divisions. [emedicine.medscape.com]
Pathophysiology of 3 phases • Initiation– tubular cells begin to lose concentrating ability. • Oliguric – tubular epithelium lost, so there is reabsorption of most of the glomerular filtrate. • Diuretic – regenerating epithelium can’t yet concentrate, [slideshare.net]
Prevention
[…] radiation nephritis may present with hypertension, anaemia, proteinuria or end-stage renal failure 2-5 years after radiotherapy treatment Treatment: treatment of hypertension if end-stage renal therapy then renal replacement therapy e.g. haemodialysis Prevention [gpnotebook.co.uk]
Radiation nephropathy may be prevented by renal shielding and mitigated by radiation dose fractionation. [oxfordmedicine.com]
• Diuretic – regenerating epithelium can’t yet concentrate, but does prevent much reabsorption. (once concentrating ability restored, complete return to normal) 13. [slideshare.net]
Treatment: Blood pressure control with ACE inhibitors or Angiotensin Receptor Blockers (AT 1 blockers) AT 1 blockade may be more effective than ACE inhibition in prevention of XRT Nehropathy Limiting the dose of radiation Dose recommendations are only [renalandurologynews.com]