Abstract
Unilateral kidney irradiation, above renal tolerance, is occasionally necessary in the treatment of flank tumours in childhood. Renal atrophy follows. There is often a gradual increase in the function of the contralateral kidney to compensate for the radiation injury. The development of this compensatory response appears to be influenced by both age and any dose of radiation received. We report the cases of two children who received high dose unilateral kidney radiotherapy as part of the multimodality treatment of a flank tumour and consider the influences on compensatory hypertrophy of the contralateral kidney.