Clinical findings:
(1) hypertension
(2) proteinuria
(3) progressive renal failure (deterioration in GFR, with increases in BUN and creatinine)
(4) anemia
Histologic findings:
(1) glomerulosclerosis
(2) tubulointerstitial fibrosis with tubular atrophy and fibrosis
(3) arteriolarnephrosclerosis affecting arterioles and capillaries
Factors affecting onset:
(1) single vs both kidneys in radiation field
(2) partial vs total kidney in radiation field
(3) radiation dose (threshold for adults 15 Gy, with low rates at 20 Gy, increasing as the dose increases)
(4) age of the patient (children affected at a lower radiation dose than adults)
(5) time of followup (lower exposures may take longer to appear)
(6) pre-existing renal disease
Differential diagnosis:
(1) diabetes nephropathy
(2) atherosclerosis
(3) hypertensive nephropathy
(4) chemotherapy-related nephrotoxicity
(5) analgesic nephropathy
(6) associated with the underlying malignancy (myeloma kidney, etc.)
