Onconephrology

Abstract

Renal diseases in patients with cancer have many unique features, and often these diseases require specialized approaches. Newer cancer therapy has increased cancer cure rate and survival time, but such benefit is not fully realized, partly because of therapy-associated toxicities. Fluid and electrolyte abnormalities are very common in patients with cancer, as are acute and chronic kidney injury. With the evolving complexities of newer cancer therapies, a comprehensive team approach is becoming necessary. It is essential for nephrologists to be informed and involved in cancer care. Many nephrologists caring for patients with cancer in the United States have recently met and formed a focus group, the OncoNephrology Forum, under the American Society of Nephrology. This update addresses what is clinically unique about onconephrology, the objectives and functions of the newly formed forum, and the potential of onconephrology becoming a subspecialty in nephrology.

Predictors of Recurrent AKI

“…27 The improved survival along with advances in available, but potentially nephrotoxic therapies, has resulted in cancer becoming an increasingly important contributor to the changing AKI case mix. [28][29][30][31] Not surprisingly, the need to enhance our hospitalization with recurrent AKI (solid line) or death/hospice referral (dash-dotted line) as the first event experienced. The corresponding numbers and proportions of patients experiencing each event are shown in Table 2.…”

“…understanding of the potential renal sequelae (i.e., "onconephrology") is recognized by the American Society of Nephrology as a growing area of interest. 28 Whether the risk of AKI recurrence in this population is mediated by exposure to chemotherapy or from underlying cancer is not known, highlighting an important area for future study. However, we did find that inpatient chemotherapy was no longer associated with recurrent AKI beyond 90 days, suggesting that the timing of renal complications relating to inpatient chemotherapy or its re-administration is likely to occur earlier.…”

Acute kidney injury in cancer patients and impedance cardiography‑assisted renal replacement therapy: Experience from the onconephrology unit of a Chinese tertiary hospital

“…With increasingly complex cancer treatment protocols, novel antineoplastic drugs and a growing emphasis on AKI in cancer patients, onconephrology has evolved into a new field of nephrology (13). It is an intersection between nephrology and oncology, in which nephrologists are required to be familiar with the epidemiology, etiology and treatment of AKI in cancer patients.…”

“Clinical Profile of Acute Kidney Injury in Cancer Patients”

“…Onconephrology is an emerging discipline that covers the interrelations between cancer and kidney diseases (1). Acute kidney injury (AKI) is a common complication in patients with cancer, and indeed certain clinical entities, such as tumor lysis syndrome and syndrome of inappropriate antidiuretic hormone have close associations with cancer (2).…”