179:(CKD) have significantly lower survival than the general population. One area of substantial interest is the estimation of kidney function in cancer patients, as it has direct impact on chemotherapy dosing, selection, and eligibility for chemotherapeutics. Overestimating kidney function can lead to overdosing and drug toxicity while underestimating kidney function can prevent patients from receiving key novel therapies. Further studies are necessary to determine the most accurate estimation formula of renal function. Overall, a collaborative approach with oncologists and onconephrologists are important in managing CKD and addressing concerns such as renal replacement therapy and transplant in this population.
131:(AKI) is a commonly feared complication in cancer patients as it can interrupt life saving therapy and potentially have mortality implications. The exact incidence of AKI in this population can vary. In one retrospective study of a single center ICU the risk was as high as 6% and 60 day survival was low as 14% in those requiring dialysis. AKI in this population can be due to volume depletion from vomiting and
332:
39:
who takes care of patients with cancer and kidney disease is called an onconephrologist. This branch of nephrology encompasses nephrotoxicity associated with existing and novel chemotherapeutics, kidney disease as it pertains to stem cell transplant, paraneoplastic kidney disorders, paraproteinemias
76:
Additionally, there is
Increased recognition that primary hematological and oncological disorders can have an impact on the kidneys in the form of glomerular disease that can present with proteinuria, hematuria, hypertension, and kidney function decline. Examples include, hematological cancers such
293:
To be considered an onconephrologist one must complete medical school, an internal medicine residency, and a general nephrology subspecialty training. After general nephrology, one may consider an optional subspecialty training in onconephrology in a few select academic centers that offer the 3rd
392:
The
American Society of Onconephrology (ASON) was co-founded on December 15, 2021, by Shruti Gupta and Kenar D. Jhaveri. Other founding members include Arash Rashidi who will be serving as treasurer and Biruh T. Workeneh serving as secretary. The official mission per their website is "to promote
187:
Large academic centers in the United States and other countries have started forming an onconephrology related patient approach to manage these complex disorders as above. Therapy can be as simple as limiting offending agents and dose adjustment of chemotherapeutics or as intricate as adding
294:
year track. Centers that offer this training include
Memorial Sloan Kettering, MD Anderson, Northwell Health( Hofstra), Mayo Clinic, and the University of Toronto. Currently, no board certification process exists and this additional year of training is optional.
48:
As onconephrologists are primarily taking care of kidney disease in cancer patients, there are several aspects that are unique to this practice when compared to general nephrology. For example, patients receiving chemotherapy can experience
393:
research, clinical activities, and education related to onconephrology". ASON also launched an official twitter account under the handle @onconephsociety. The next Onco-Nephrology
Symposium will be held on September 30, 2022, and hosted by
208:, but sometimes can be delayed based on the tumor type and risk of reoccurrence. Immunosuppressive therapy use after transplantation can increase risk of malignancies such as skin cancers and rarely cause
314:
formed the first ever
Onconephrology Forum (ONF) under the leadership of Salahudeen and Bonventre focusing on onconephrology at national levels. There is a journal dedicated to this field called the
175:
With more effective management options for cancer patients, there are far more cancer survivors with residual decline in kidney function from the causes mentioned above. Patients with cancer and
65:
and is a common electrolyte disturbance seen in this population. Fluid, electrolytes and acid base disturbances are much more common and often severe in those who receive chemotherapy. Several
53:
from destruction of cancer cells. There are also various complex electrolyte disorders that can occur due to the cancer itself or are side effects of chemotherapeutics. One example, the
135:
that occur following chemotherapy or occasionally due to kidney toxicities of chemotherapeutic agents. Less frequently AKI can occur due to obstruction to urine flow from tumor,
54:
209:
543:
Lahoti A, Nates JL, Wakefield CD, Price KJ, Salahudeen AK (July 2011). "Costs and outcomes of acute kidney injury in critically ill patients with cancer".
213:
455:"The evaluation of monoclonal gammopathy of renal significance: a consensus report of the International Kidney and Monoclonal Gammopathy Research Group"
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but risk of reoccurrence is common. For these reasons, the role of transplantation continues to be an area of active discussion and expansion.
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580:"Hypertension induced by vascular endothelial growth factor signaling pathway inhibition: mechanisms and potential use as a biomarker"
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762:"Kidney Transplantation in Patients With Monoclonal Gammopathy of Renal Significance (MGRS)-Associated Lesions: A Case Series"
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Otley CC, Hirose R, Salasche SJ (September 2005). "Skin cancer as a contraindication to organ transplantation".
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163:. Additionally, cancer cells can cause AKI by infiltrating the kidney or by precipitating with in the
40:(myeloma and amyloidosis), electrolyte disorders associated with cancer, and more as discussed below.
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https://global.oup.com/academic/product/cancer-and-the-kidney-9780199580194?cc=us&lang=en&
670:"Estimation of Kidney Function in Oncology: Implications for Anticancer Drug Selection and Dosing"
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Leung N, Bridoux F, Batuman V, Chaidos A, Cockwell P, D'Agati VD, et al. (January 2019).
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Heybeli C, Alexander MP, Bentall AJ, Amer H, Buadi FK, Dean PG, et al. (June 2021).
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139:, or due to vascular microthrombi as seen in thrombotic microangiopathies such as
81:(paraproteinemias), which can have significant kidney implications in the form of
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Thrombotic microangiopathy and all its causes and treatment strategies (HUS/TTP)
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629:"Onconephrology: the latest frontier in the war against kidney disease"
414:"Onconephrology: the latest frontier in the war against kidney disease"
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27:, and the suffix -logy (-λογία), meaning "study of") is a specialty in
578:
Robinson ES, Khankin EV, Karumanchi SA, Humphreys BD (November 2010).
188:
immunosuppressive regimens. Renal
Replacement therapy in the form of
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24:
100:
Onco-nephrology also encompasses kidney diseases that are unique to
212:. Some centers may offer kidney transplantation in the setting of
151:(anti-VEGF) are also associated with similar injuries, as well as
20:
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Targeted therapy and immunotherapy associated kidney toxicities
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224:
Topics that are usually of interest to onconephrologists are:
108:
patients. Certain kidney diseases associated with SCT include
19:(from the Ancient Greek onkos (ὄγκος) meaning bulk, mass, or
104:(stem cell transplant or SCT) which are frequently seen in
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Brigham and Women's
Hospital/Dana-Farber Cancer Institute.
73:– are associated with acute and chronic kidney injuries.
817:
Jhaveri, Kenar D.; Salahudeen, Abdulla K., eds. (2015).
349:
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Acute kidney injury in the hospitalized cancer patient.
674:
Clinical
Journal of the American Society of Nephrology
204:
Active malignancy is generally a contraindication for
360:, and by adding encyclopedic content written from a
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Chronic kidney disease related to cancer and therapy
304:
Onconephrology: Cancer, Chemotherapy and the Kidney
302:Several textbooks have been written on this topic.
262:The ethics of dialysis in the dying cancer patient
310:by Cohen by Oxford Univ Press In addition, the
97:which can be as a result of occult malignancy.
502:Finkel KW, Perazella MA (2020). "Dedication".
250:Bone marrow transplant related kidney diseases
55:syndrome of inappropriate antidiuretic hormone
633:Journal of the American Society of Nephrology
418:Journal of the American Society of Nephrology
210:post-transplant lymphoproliferative disorders
8:
668:Casal MA, Nolin TD, Beumer JH (April 2019).
627:Salahudeen AK, Bonventre JV (January 2013).
412:Salahudeen AK, Bonventre JV (January 2013).
196:is also considered in these patients during
232:Secondary glomerular diseases of malignancy
214:monoclonal gammopathy of renal significance
306:by Jhaveri and Salahudeen by Springer and
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380:Learn how and when to remove this message
171:Chronic kidney disease in cancer patients
238:Chemotherapy related renal complications
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149:anti-vascular endothelial growth factor
341:contains content that is written like
124:Acute kidney injury in cancer patients
61:concentration, was first described in
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194:continuous renal replacement therapy
766:American Journal of Kidney Diseases
719:American Journal of Transplantation
229:Electrolyte disorders of malignancy
141:thrombotic thrombocytopenic purpura
545:The Journal of Supportive Oncology
512:10.1016/b978-0-323-54945-5.00003-5
322:American Society of Onconephrology
235:Cancer related renal complications
145:atypical hemolytic uremic syndrome
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731:10.1111/j.1600-6143.2005.01036.x
596:10.1016/j.semnephrol.2010.09.007
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265:Dialysis and chemotherapy agents
241:Myeloma related kidney diseases
114:sinusoidal obstruction syndrome
312:American Society of Nephrology
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167:as seen in paraproteinemias.
31:that deals with the study of
557:10.1016/j.suponc.2011.03.008
268:Tumor invasion of the kidney
506:. Elsevier. pp. v–vi.
57:(SIADH), a disorder of low
23:, nephros (νεφρός) meaning
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778:10.1053/j.ajkd.2021.04.015
459:Nature Reviews. Nephrology
161:thrombotic microangiopathy
118:thrombotic microangiopathy
829:10.1007/978-1-4939-2659-6
471:10.1038/s41581-018-0077-4
316:Journal of Onconephrology
280:CKD following nephrectomy
271:Obstructive renal disease
110:Graft-versus-host disease
202:end stage renal disease.
85:or systemic light chain
220:Specific areas of focus
200:or diseases leading to
147:. Newer agents such as
79:monoclonal gammopathies
67:chemotherapeutic agents
646:10.1681/ASN.2012070690
584:Seminars in Nephrology
431:10.1681/asn.2012070690
206:kidney transplantation
177:chronic kidney disease
137:lymph node enlargement
102:bone marrow transplant
95:minimal change disease
91:membranous nephropathy
35:in cancer patients. A
362:neutral point of view
308:Cancer and the Kidney
253:Radiation nephropathy
686:10.2215/CJN.11721018
256:Tumor lysis syndrome
354:promotional content
198:acute renal failure
129:Acute kidney injury
356:and inappropriate
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87:amyloidosis
63:lung cancer
880:Nephrology
400:References
370:March 2024
350:improve it
298:Literature
183:Management
29:nephrology
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