Radiation therapy as a cause of renal functions` impairment and arterial hypertension in patients with urogenital malignancies

The aim of this study was to estimate the state of the renal functions in patients with urogenital tumors treated with irradiation in order to reveal patients with chronic radiation nephropathy. The retrospective analysis of 18 pts (8 F with diagnosis carcinoma of uterus or uterine cervix, mean age 54 ± 5,7 ys, total irradiation dose 55,6 ± 12,9 Gy and 10 M with diagnosis prostate cancer, mean age 59,3 ± 6,1 ys, total irradiation dose 76,6 ± 22,4 Gy) was undertaken. All patients were successfully treated with surgical intervention and irradiation in complex. Non patient have renal diseases or significant systemic hypertension before surgical and radiation treatment. The statement of renal functions was evaluated 2-4 months after irradiation (initial point) and 18 months after irradiation (late postirradiation period) by serum creatinine level and estimated glomerular filtration rate (Cockcroft-Gault formula). The dynamics of systolic and diastolic blood pressure was also monitored. The renal function impairment was observed in most patients in late postirradiation period: 50% pts had pronounced decline of glomerular filtration rate along with rising of serum creatinine level and development of moderate arterial hypertension in some of them; 22% pts had mild decline of glomerular filtration rate with slightly elevated blood pressure in some pts. In 28% of patients renal functions and blood pressure in late postirradiation period were similar to their initial levels. Chronic radiation nephropathy may be a common late complication after radiotherapy and may be found in half of patients with urogenital tumors. Such patients should be timely tested for the ascertainment of chronic radiation nephropathy. The first appearance of renal impairment symptoms in early postirradiation period may indicate acute radiation nephropathy with the possibility of subsequent chronic radiation nephropathy.

радиационная нефропатия, лучевая терапия, нарушение функции почек, артериальная гипертензия, тромботическая микроангиопатия

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