Onconephrology: Understanding Kidney Diseases in Cancer Patients

What is Onconephrology?

Onconephrology is a specialized field that focuses on the relationship between cancer and kidney health. Cancer and its treatments can significantly impact kidney function, leading to acute kidney injury (AKI), chronic kidney disease (CKD), and electrolyte imbalances. Kidney complications in cancer patients can arise from:

• Kidney Cancer – Primary tumors originating in the kidneys.
• Nonrenal Cancers – Cancers that indirectly affect kidney function.
• Cancer Treatments – Chemotherapy, targeted therapy, and immunotherapy that can damage the kidneys.

Common Kidney-Related Issues in Cancer Patients

Cancer and its treatments can lead to various kidney-related complications, including:

1. Acute Kidney Injury (AKI)

• Can be caused by chemotherapy, dehydration, tumor lysis syndrome, or nephrotoxic drugs.
• Requires early detection and management to prevent permanent kidney damage.

2. Chronic Kidney Disease (CKD)

• Long-term renal damage due to cumulative effects of cancer therapies or comorbid conditions.
• Patients may require kidney function monitoring and medication adjustments.

3. Fluid and Electrolyte Imbalances

• Cancer and chemotherapy can cause hypercalcemia, hypokalemia, and hyponatremia, leading to severe complications.

4. Proteinuria and Glomerular Diseases

• Cancer and immunotherapy can trigger glomerular diseases like membranous nephropathy or minimal change disease.

5. Hypertension and Kidney Damage

• Cancer treatments, especially vascular endothelial growth factor (VEGF) inhibitors, can increase blood pressure and cause renal injury.

6. Tumor Lysis Syndrome (TLS)

• A life-threatening condition where rapid breakdown of cancer cells releases toxins, leading to acute kidney injury and metabolic imbalances.

How Cancer Treatments Impact Kidney Function

Many cancer therapies have nephrotoxic effects, making kidney monitoring essential.

Chemotherapy and Kidney Damage

• Cisplatin, Methotrexate, Ifosfamide – Can cause direct nephrotoxicity leading to AKI.
• Dose adjustments are necessary for patients with impaired kidney function.

Targeted Therapies & Immunotherapy

• VEGF inhibitors, tyrosine kinase inhibitors – May lead to proteinuria, hypertension, and renal damage.
• Immune checkpoint inhibitors – Can trigger autoimmune kidney disorders, such as glomerulonephritis.

Approach to Onconephrology Care

Proper management of kidney complications in cancer patients involves:

1. Preventive Strategies

• Hydration before chemotherapy to prevent AKI and electrolyte disturbances.
• Medication adjustments based on kidney function.

2. Early Diagnosis and Monitoring

• Regular renal function tests (serum creatinine, GFR, urine protein levels).
• Monitoring for signs of kidney damage or drug-induced nephrotoxicity.

3. Treatment of Kidney Complications

• Managing AKI with supportive care, IV fluids, and dialysis if needed.
• CKD management with medications to control blood pressure, proteinuria, and electrolyte imbalances.

4. Multidisciplinary Collaboration

• Nephrologists and oncologists work together to balance cancer treatment while protecting kidney health.

Consult Dr. Sandip Bhurke – Expert Onconephrologist in Mumbai

If you are a cancer patient experiencing kidney complications, consult Dr. Sandip Bhurke, a leading nephrologist in Mumbai specializing in onconephrology.

Why Choose Dr. Sandip Bhurke?

✔ Expert in managing kidney complications from cancer treatments
✔ Specialist in acute and chronic kidney disease in cancer patients
✔ Personalized treatment plans to optimize cancer therapy while preserving kidney function.