Kamiya and colleagues (Aug 1, p 469)1 provide a timely report of the late-onset effects of wartime and accidental radiation exposure and briefly mention chronic kidney disease as a potential late-onset effect. Chronic kidney disease is a clinically significant, but underappreciated, late-onset complication of haemopoietic stem-cell transplantation that is often linked to total body irradiation before transplantation.2 Partial or total body exposures to radiation doses as low as 5 Gy in a single fraction are not lethal but can lead to radiation nephropathy.3 Exposures to even lower doses of radiation are associated with late cardiovascular and renal disease.4 Chronic kidney disease substantially increases human morbidity and mortality,5 and renal function should be part of the immediate and long-term follow-up of individuals who have had substantial clinical or accidental radiation exposures to parts of the body that include the kidneys.
Acknowledgments
EPC reports grants from the US Department of Veterans Affairs. JEM reports grants from the National Institutes of Health, the American Cancer Society, and the US Department of Veterans Affairs. BLF declares no competing interests.
Contributor Information
Eric P Cohen, Baltimore VA Medical Center and the University of Maryland School of Medicine, Baltimore, MD, USA.
Brian L Fish, Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
John E Moulder, Department of Radiation Oncology, Medical College of Wisconsin, Milwaukee, WI, USA.
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