Effects of single doses of X-rays on renal function in the pig after the irradiation of both kidneys

Abstract

Irradiation of a single kidney in the pig with relatively low doses of X-rays, in the order of 8 Gy, produces a pronounced reduction in both glomerular filtration rate (GFR) and effective renal plasma flow (ERPF). This apparent high radiosensitivity may be due, in part, to the compensatory hypertrophy displayed by the contralateral unirradiated kidney. This could suppress any potential for recovery by the irradiated kidney. To test this hypothesis, both kidneys of 14-week-old Large White pigs were sequentially irradiated with single doses of 250 kV X-rays, in the range 8.8 to 12.6 Gy. Sequential measurements of individual kidney GFR and ERPF were made for periods up to 24 weeks after irradiation. Time-related changes in haematocrit (Hct) were also studied. Two weeks after irradiation, GFR and ERPF increased markedly in all irradiated kidneys; levels then declined in a dose-dependent manner. Following a dose of 8.8 Gy renal haemodynamics returned to control values within 4 weeks of irradiation and remained essentially constant throughout the study. After higher doses, GFR and ERPF decreased markedly and remained below control values up to 24 weeks after irradiation. Associated with these changes in renal haemodynamics was a fall in Hct within 3 weeks of irradiation, with minimal levels being found approximately 8 weeks after irradiation. Although there was some recovery between weeks 12 and 24, Hct values remained below those of age-matched controls. At all doses the mean functional status of irradiated kidneys in animals in which both kidneys were irradiated (BI) was significantly greater than that previously observed in the irradiated kidney of pigs in which only one kidney was irradiated (UI). Moreover, in BI pigs there appeared to be a marked imbalance between the contribution each kidney makes to the total renal function. In terms of ERPF, the functional status of the right kidney, relative to that of the left kidney, showed a dose-related decline. These findings support the hypothesis that the compensatory response exhibited by the contralateral unirradiated kidney in UI pigs suppresses the potential for functional recovery by the irradiated kidney. The findings also indicate that individual kidneys in the same animal may differ in their response to a similar nephrotoxic insult.