The Radiation Therapy Oncology Group (RTOG) and the European Organization for Research on the Treatment of Cancer (EORTC) provide criteria for assessing the complications of radiation therapy affecting the kidneys.
Guidelines:
(1) Change in affected parameter is ascribed to radiation therapy and not underlying or concurrent disease.
(2) Considered acute if occurs from day 1 to 90; after day 90 considered late complication.
Acute Complications
No acute complications are described.
Late Complications
Grade 0
(1) no change from baseline
(2) albuminuria: none
(3) hypertension: none
(4) impairment of renal function: none
(5) BUN: < 25 mg/dL
(6) creatinine: < 1.5 mg/dL
(7) creatinine clearance: >= 80 mL/min
(8) anemia: none
|
Injury |
Grade 1 |
Grade 2 |
Grade 3 |
Grade 4 |
|
albuminuria |
transient |
persistent and moderate (2+) |
severe |
NA |
|
hypertension |
none |
mild |
severe |
malignant |
|
impaired renal function |
mild |
moderate |
severe |
uremic coma |
|
BUN |
25-35 mg/dL |
36-60 mg/dL |
> 60 mg/dL |
> 100 mg/dL |
|
creatinine |
1.5-2.0 mg/dL |
2.1-4.0 mg/dL |
> 4.0 mg/d |
|
|
creatinine clearance |
50-79 mL/min |
28 - 49 mL/min |
1 - 27 mL/min |
0 mL/min (anuric) |
|
anemia |
none |
none |
persistent, hemoglobin < 10 g/dL |
NA |
Grade 5: death secondary to renal failure caused by irradiation
where:
• Data on creatinine clearance is expressed in percent in the source table. I've switched to clearance in mL/min based on data in the chapter on the kidney.
Purpose: To grade symptoms caused by renal damage following radiation exposure.
Specialty: Hematology Oncology, Nephrology
Objective: adverse effects
ICD-10: C64,
