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August 9, 2019

Disease Week: Onco-Nephrology

The rapidly evolving field of oncology and cancer management creates unique opportunities as well as challenges for the nephrology community.  As such, it is important for nephrologists and nephropathologists to be informed and involved in its many aspects in order to better care for patients and be valuable members of a multidisciplinary cancer care team.  The renal manifestations and complications of cancer are myriad and include acute as well as chronic kidney injury, electrolyte/acid–base disturbances, direct injury of the kidney through tumor infiltration and/or paraneoplastic substances, pharmacokinetics of chemotherapeutic agents, and hematopoietic cell transplantation-related kidney injury.  Kidney transplant patients also have an increased risk of cancer, which is often more aggressive, making routine surveillance and early detection and treatment essential.  As nephropathologists, we have seen increasing biopsies with acute and chronic kidney injury related to newer chemotherapies and immunotherapies as well as effects of stem cell transplantation.  Finally, the importance of early palliative care for patients with advanced kidney disease and cancer should not be overlooked as well as the possibility of incorporating palliative care into dialysis facility patient care.  I hope I have convinced you this week that the field of onco-nephrology is continually advancing and vitally important as we care for an increasing number of cancer patients in our practices.  Luckily, the ASN has a comprehensive online curriculum with 19 chapters covering the most important topics in onco-nephrology that can be accessed here: https://www.asn-online.org/education/distancelearning/curricula/onco/.