The association between kidney disease and cancer is multifaceted and complex. Persons with chronic kidney disease (CKD) have an increased incidence of cancer, and both cancer and cancer treatments can cause impaired kidney function. Renal issues in the setting of malignancy can worsen patient outcomes and diminish the adequacy of anticancer treatments. In addition, the oncology treatment landscape is changing rapidly, and data on tolerability of novel therapies in patients with CKD are often lacking. Caring for oncology patients has become more specialized and interdisciplinary, currently requiring collaboration among specialists in nephrology, medical oncology, critical care, clinical pharmacology/pharmacy, and palliative care, in addition to surgeons and urologists. To identify key management issues in nephrology relevant to patients with malignancy, KDIGO (Kidney Disease: Improving Global Outcomes) assembled a global panel of multidisciplinary clinical and scientific expertise for a controversies conference on onco-nephrology in December 2018. This report covers issues related to kidney impairment and solid organ malignancies as well as management and treatment of kidney cancer. Knowledge gaps, areas of controversy, and research priorities are described.
Kidney international. 2020 Nov [Epub]
Camillo Porta, Aristotelis Bamias, Farhad R Danesh, Alicja Dębska-Ślizień, Maurizio Gallieni, Morie A Gertz, Jan T Kielstein, Petra Tesarova, Germaine Wong, Michael Cheung, David C Wheeler, Wolfgang C Winkelmayer, Jolanta Małyszko, Conference Participants
Department of Internal Medicine and Therapeutics, University of Pavia and Division of Translational Oncology, IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy. Electronic address: ., Second Propaedeutic Department of Internal Medicine, National and Kapodistrian University of Athens, Greece., Section of Nephrology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA., Clinical Department of Nephrology, Transplantology and Internal Medicine, Medical University of Gdańsk, Gdańsk, Poland., Nephrology and Dialysis Unit, Luigi Sacco Department of Biomedical and Clinical Sciences, Università di Milano, Milan, Italy., Division of Hematology, Department of Medicine, Mayo Clinic, Rochester, Minnesota, USA., Medical Clinic V, Nephrology, Rheumatology, Blood Purification, Academic Teaching Hospital Braunschweig, Braunschweig, Germany., Department of Oncology, 1st Faculty of Medicine, Charles University and General University Hospital, Prague, Czech Republic., Centre for Kidney Research, The Children's Hospital at Westmead, Westmead, New South Wales, Australia; Sydney School of Public Health, University of Sydney, New South Wales, Australia., KDIGO, Brussels, Belgium., Department of Renal Medicine, University College London, London, UK; George Institute for Global Health, Sydney, Australia., Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine, Houston, Texas, USA., Department of Nephrology, Dialysis, and Internal Medicine, Medical University of Warsaw, Poland. Electronic address: .