Abstract
ONCONEPHROLOGY: NEW SUBSPECIALTY, OLD PROBLEMS

*P. Bartnicki and J. Jagie?a and J. Rysz

ABSTRACT

Literature data indicates the interdependence between kidney diseases and cancer. Chronic kidney disease (CKD) is a risk factor of cancer development, and cancer or its treatment can lead to kidney damage.[1] It is important because the occurrence of CKD as well as cancer is growing with age.[2] In patients with CKD progression, cancer frequency increases with the estimated glomerular filtration rate (eGFR) decline and it is especially high in patients treated with dialysis. Moreover, cancer frequency is higher in patients after kidney transplantation in comparison to the general population.[3] Cancer diagnosis and treatment in CKD patients can be hampered especially in later CKD stages when eGFR is lower than 30 ml/min.[4] It concerns the possibility of performing imaging examination with contrast medium, interpreting concentrations of cancer biomarkers in patients’ blood, and using specialized oncological treatment, e.g. chemotherapy. These limitations cause that results of cancer treatment in CKD patients are significantly worse in comparison to the general population. On the other hand, cancer and its treatment can cause kidney damage.[5] It is well known that nephrotoxicity of drugs used in oncology can lead to acute kidney injury (AKI) or CKD progressing with the eGFR decline, which makes treatment continuation impossible.[6,7] Cessation of oncological treatment or reduction in doses of oncological drugs due to kidney function deterioration is the main reason for worsening of cancer treatment results in these patients. Decline in kidney excretory function is the reason for the limitation of using new oncological therapies, for example molecular ones, in patients with advanced CKD.[8] Thus cancer diagnosis and treatment in CKD patients are a big challenge for nephrologists and oncologists. The new subspecialty, onconephrology, deals with the described above problems of cancer and kidney diseases.[9] In this article, the authors discuss only some chosen onconephrology problems such as cancer occurrence in CKD patients and some problems associated with cancer diagnosis and treatment.

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