Introduction to the Journal of Onco-Nephrology

Abstract

EDITORIAL nale et Médicaments Anticancéreux-Renal Insufficiency and Anticancer Medications). These two cohorts included about 10,000 adult cancer patients with solid tumors (mainly breast, colorectal, and lung). Approximately half of them were nonmetastatic at the time of inclusion, and not on dialysis (1, 2). In these cohorts, 52.9% and 50.2% of the patients in IRMA-1 and IRMA-2, respectively, had a reduced eGFR (lower than 90 mL/min/1.73 m²), and 12.0% and 11.8% had stage 3 or 4 RI (lower than 60 mL/min/1.73 m²). Interestingly, cancer patients rarely present with a normal eGFR. Several other studies have reported on the prevalence of RI in cancer patients. For instance, in patients with kidney cancer, Huang et al (3) reported a particularly high (87%) prevalence of abnormal renal function (lower than 90 mL/min/1.73 m²) in a cohort of 662 patients with a renal cortical tumor (<4 cm) awaiting partial or radical nephrectomy. The prevalence of an eGFR lower than 60 mL/min/1.73 m² was also higher than the one reported in the IRMA studies, with 26% of the patients with at stage 3-4 RI. Other studies in Belgium (4), the USA (5), Japan (6), and Austria (7) reported the prevalence of an eGFR <60 mL/min/1.73 m 2 of 16.1%, 22.0%, 25.0%, and 14.7 to 16.1%, respectively. In the IRMA-2 study, the potential impact of RI on patient survival had been assessed through a 2-year follow-up. The results showed that patients with an eGFR lower than 60 mL/min/1.73 m² at the time of inclusion in the study had a significantly lower survival rate compared to patients with an eGFR greater than or equal to 60 mL/min/1.73 m². Considering the 2,382 patients who had a nonmetastatic disease, the impact of RI on survival was still significant. The survival was 21.0 vs. 25.0 months for patients with an eGFR lower than or equal to 60 mL/min/1.73 m², respectively.

Evolution of the kidney–cancer connection

“…2 Acquiring these clinical skills will allow “onco-nephrologists” to handle the vast number of cancer patients who develop kidney disease. 3…”

Update on the Renal Effects of Anticancer Agents

“…Cancer and kidney disease are common causes of morbidity and death (1-3). It has been recognized that a unique connection exists between these two diseases in that kidney disease is a relatively common complication of various malignant conditions.…”

“…The observed increase in kidney disease in cancer survivors and those with active cancer is likely related to a number of factors. These include high incidence rates for many malignancies, shared risk factors for cancer and kidney disease, and the overall reduction in cancer deaths due to more effective chemotherapeutic agents, which increases patient exposure to potentially nephrotoxic medications (1-3). The rapidly evolving area of anticancer drug nephrotoxicity requires nephrologists, oncologists, and other clinicians who provide care for cancer patients to become familiar with these drug complications.…”

New Horizons in Nephrology: Update in Onco-Nephrology

“…In addition, health care providers must accumulate the appropriate knowledge base and clinical skills to yield outstanding diagnostic and management skills for the spectrum of kidney disease that develops in patients with malignant processes (2). These skills will permit clinicians to provide outstanding and competent care for the overwhelming majority of kidney diseases that occur in patients with cancer (3).…”