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Table 1 Areas of special importance in the field of onco-nephrology

From: Cancer screening and treatment in patients with end-stage renal disease: remaining issues in the field of onco-nephrology

Areas

Comments

 

The representative areas in (A)~(C) can be described as follows (the details were reviewed previously [1]).

(A) Acute kidney injury in cancer patients

The causes of AKI in cancer patients can be categorized as prerenal, intrinsic, and postrenal.

• Prerenal (extracellular fluid depletion, hypercalcemia, hepatic sinusoidal occlusive syndrome, drugs)

• Intrinsic (acute tubular necrosis, lymphomatous infiltration of the kidney, cast nephropathy, tumor lysis syndrome, thrombotic microangiopathy, secondary glomerulopathies)

• Postrenal (extrarenal obstruction due to primary disease, retroperitoneal lymphadenopathy, retroperitoneal fibrosis)

(B) Paraneoplastic glomerulopathies

• Solid malignancy-associated membranous nephropathy

• Hematologic malignancy-associated minimal change disease

(C) Chemotherapy-associated kidney manifestations

• Minimal change disease and focal segmental glomerulosclerosis (interferon, pamidronate)

• Acute tubular necrosis and electrolyte wasting (cisplatin)

• Magnesium wasting (cetuximab)

• Thrombotic microangiopathy (bevacizumab, tyrosine kinase inhibitors, and gemcitabine)

• Cast nephropathy (methotrexate)

(D) Cancer risk and screening in patients with ESRD

Although the etiologies of cancer-associated renal diseases in (A)~(C) are relatively well understood, the protocols of the cancer screening and effective anti-cancer treatment for ESRD patients are not established yet.

(E) Anti-cancer chemotherapy in patients with ESRD