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Onconephrology: The intersections between the kidney and cancer.
Literature Information
| DOI | 10.3322/caac.21636 |
|---|---|
| PMID | 32853404 |
| Journal | CA: a cancer journal for clinicians |
| Impact Factor | 232.4 |
| JCR Quartile | Q1 |
| Publication Year | 2021 |
| Times Cited | 64 |
| Keywords | acute kidney injury, chemotherapy, chronic kidney disease, electrolytes, glomerulonephritis |
| Literature Type | Journal Article, Review |
| ISSN | 0007-9235 |
| Pages | 47-77 |
| Issue | 71(1) |
| Authors | Mitchell H Rosner, Kenar D Jhaveri, Blaithin A McMahon, Mark A Perazella |
TL;DR
Onconephrology is an emerging nephrology subspecialty that addresses the complex relationship between kidney disease and cancer, including issues like drug-induced nephrotoxicity and electrolyte disorders. The review emphasizes the need for collaborative care between oncologists and nephrologists to improve patient outcomes, highlighting the establishment of specialized training and clinics to tackle these challenges effectively.
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acute kidney injury · chemotherapy · chronic kidney disease · electrolytes · glomerulonephritis
Abstract
Onconephrology is a new subspecialty of nephrology that recognizes the important intersections of kidney disease with cancer. This intersection takes many forms and includes drug-induced nephrotoxicity, electrolyte disorders, paraneoplastic glomerulonephritis, and the interactions of chronic kidney disease with cancer. Data clearly demonstrate that, when patients with cancer develop acute or chronic kidney disease, outcomes are inferior, and the promise of curative therapeutic regimens is lessened. This highlights the imperative for collaborative care between oncologists and nephrologists in recognizing and treating kidney disease in patients with cancer. In response to this need, specific training programs in onconephrology as well as dedicated onconephrology clinics have appeared. This comprehensive review covers many of the critical topics in onconephrology, with a focus on acute kidney injury, chronic kidney disease, drug-induced nephrotoxicity, kidney disease in stem cell transplantation, and electrolyte disorders in patients with cancer.
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Primary Questions Addressed
- How do different types of cancer influence the risk and severity of drug-induced nephrotoxicity?
- What are the latest advancements in managing electrolyte disorders in cancer patients with kidney disease?
- How can collaborative care models between oncologists and nephrologists be optimized for better patient outcomes?
- What role does chronic kidney disease play in the prognosis of cancer patients undergoing chemotherapy?
- How do specific training programs in onconephrology address the challenges faced by nephrologists treating cancer patients?
Key Findings
Key Insights
Research Background and Purpose: The emerging field of onconephrology addresses the critical overlap between nephrology and oncology, particularly focusing on how kidney diseases can complicate cancer treatment. Given the rising incidence of cancer and the recognition that patients with cancer are at significant risk for developing kidney-related issues, this subspecialty aims to improve patient outcomes by providing a framework for the collaborative management of kidney health in cancer patients. The purpose of this research is to explore the various intersections of kidney disease with cancer, including the mechanisms through which cancer therapies can induce nephrotoxicity and how chronic kidney disease (CKD) can alter cancer treatment efficacy.
Main Methods and Findings: The review synthesizes data from various studies highlighting significant nephrology-oncology interactions, such as drug-induced nephrotoxicity, electrolyte imbalances, and paraneoplastic syndromes like glomerulonephritis. The authors detail how acute kidney injury (AKI) and CKD are prevalent among cancer patients and demonstrate that the presence of kidney disease severely worsens treatment outcomes and survival rates. The findings underscore the necessity for specialized training in onconephrology and the establishment of dedicated clinics to manage these complex cases effectively.
Core Conclusions: The review concludes that there is a significant correlation between kidney dysfunction and adverse outcomes in cancer patients. It emphasizes the need for integrated care approaches where oncologists and nephrologists work collaboratively to identify, manage, and treat kidney issues as part of the cancer care continuum. The authors advocate for the development of specific training programs in onconephrology to bridge knowledge gaps and enhance clinical practice.
Research Significance and Impact: The emergence of onconephrology as a distinct subspecialty signifies a critical advancement in the management of cancer patients, who often have comorbid kidney issues. The insights from this research are vital for healthcare professionals involved in cancer treatment, as they highlight the importance of early recognition and intervention for kidney-related complications. This integrative approach not only aims to improve patient care but also has the potential to enhance the efficacy of cancer therapies and improve overall survival rates. The establishment of onconephrology clinics represents a proactive step towards optimizing cancer treatment protocols, ultimately fostering a multidisciplinary approach that could significantly alter the standard of care for patients facing the dual challenges of cancer and kidney disease.
Literatures Citing This Work
- The basics of onco-nephrology in the renal clinic. - Laura Cosmai;Camillo Porta;Marina Foramitti;Mimma Rizzo;Maurizio Gallieni - Journal of nephrology (2020)
- Renal Diseases Associated with Hematologic Malignancies and Thymoma in the Absence of Renal Monoclonal Immunoglobulin Deposits. - Antoine Morel;Marie-Sophie Meuleman;Anissa Moktefi;Vincent Audard - Diagnostics (Basel, Switzerland) (2021)
- Renal Complications Related to Checkpoint Inhibitors: Diagnostic and Therapeutic Strategies. - Julie Belliere;Julien Mazieres;Nicolas Meyer;Leila Chebane;Fabien Despas - Diagnostics (Basel, Switzerland) (2021)
- Kidney toxicity of the BRAF-kinase inhibitor vemurafenib is driven by off-target ferrochelatase inhibition. - Yuntao Bai;Ji Young Kim;Bijay Bisunke;Laura A Jayne;Josie A Silvaroli;Michael S Balzer;Megha Gandhi;Kevin M Huang;Veronika Sander;Jason Prosek;Rachel E Cianciolo;Sharyn D Baker;Alex Sparreboom;Kenar D Jhaveri;Katalin Susztak;Amandeep Bajwa;Navjot Singh Pabla - Kidney international (2021)
- The Crystalline Nephropathies. - Mark A Perazella;Leal C Herlitz - Kidney international reports (2021)
- Emerging Roles for G Protein-Coupled Estrogen Receptor 1 in Cardio-Renal Health: Implications for Aging. - Ravneet Singh;Victoria L Nasci;Ginger Guthrie;Lale A Ertuglu;Maryam K Butt;Annet Kirabo;Eman Y Gohar - Biomolecules (2022)
- Utility of semi-private messaging application (WhatsApp®) for Onconephrology education: a qualitative analysis of a 'mastermind' chat. - Simoni Khashu;Nitya Wanchoo;Kayla D Finuf;Sebastian Lapman;Prakash Gudsoorkar;Kenar D Jhaveri - Clinical kidney journal (2022)
- Association between chronic kidney disease and cancer including the mortality of cancer patients: national health and nutrition examination survey 1999-2014. - Kanglin Guo;Zufeng Wang;Ran Luo;Yichun Cheng;Shuwang Ge;Gang Xu - American journal of translational research (2022)
- Temporal trajectories of important diseases in the life course and premature mortality in the UK Biobank. - Xianwen Shang;Xueli Zhang;Yu Huang;Zhuoting Zhu;Xiayin Zhang;Shunming Liu;Jiahao Liu;Shulin Tang;Wei Wang;Honghua Yu;Zongyuan Ge;Mingguang He - BMC medicine (2022)
- Kidney Biopsy in Patients with Cancer along the Last Decade: A Multicenter Study. - Mónica Bolufer;Clara García-Carro;Miquel Blasco;Luis F Quintana;Amir Shabaka;Cristina Rabasco;Juliana Draibe;Ana Merino;María Rosa Melero;Fabiola Alonso;Anna Buxeda;Paula Batalha;Maria Teresa Visús;Maria José Soler - Journal of clinical medicine (2022)
... (54 more literatures)
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