Onconephrology: Cancer, Chemotherapy and the Kidney

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Onco-Nephrology Advanced Nephrology Fellowship (Minnesota)

Previous Chapter. Next Chapter. Wanchoo, Rimda, et al. The Kidney in Malignancy. Lerma E.

ACUTE KIDNEY INJURY IN THE CANCER PATIENT

Edgar V. Lerma, et al.

Onconephrology Cancer, Chemotherapy and the Kidney

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OncoNephrology (Kidney Disease in Cancer Patients)

Expand All Sections. Table Graphic Jump Location Table 17—1. Prerenal, intrinsic, and postrenal causes of AKI in the cancer patient. View Table Favorite Table Download. Sign In.


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  • View All Subscription Options. Pop-up div Successfully Displayed This div only appears when the trigger link is hovered over. Please Wait. Here, the authors review the genetic landscape of Wilms tumour and discuss how precision medicine guided by genomic information might lead to new therapeutic approaches and improve patient survival. Here, Lam and colleagues review advances in understanding the pathogenesis of tuberous sclerosis complex TSC. Immune checkpoint inhibitors ICIs have led to a paradigm shift in cancer therapy; however, these agents can induce immune-related adverse events irAEs in off-target organs.

    This Review describes the mechanism of action of ICI therapies and how these agents induce irAEs in the kidney and heart. Kidney transplant recipients have an increased risk of developing de novo or recurrent cancer compared with age-matched and gender-matched individuals from the general population. Here, Au et al.


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    • Cytoreductive nephrectomy is the current treatment paradigm for metastatic renal cell carcinoma RCC. However, the introduction of targeted therapies has dramatically changed the treatment landscape and may limit the role of nephrectomy in this disease. This Review provides an overview of the molecular determinants of renal cell carcinoma, how understanding the underlying mechanisms of disease has fuelled the development of targeted therapies, and tools to assess the value of these agents.

      Clear cell renal cell carcinoma is associated with reprogramming of metabolic pathways including glucose and fatty acid metabolism and the tricarboxylic acid cycle. Here, the authors discuss these reprogrammed pathways and the opportunities they provide for new therapies, imaging modalities and biomarkers. New data suggests that, in addition to mutations in tumour-suppressor genes, renal cancer is associated with epigenetic aberrations.

      Here, the authors discuss the mechanisms by which epigenetically silenced genes and mutations in genes that are involved in histone modification or chromatin remodelling dysregulate crucial cellular pathways in renal cancer. Here, the authors discuss the impact of genomics in identifying genes that affect susceptibility to renal cell carcinoma as well as the opportunities for a precision medicine approach to diagnosis and treatment.

      Three reports from the TRACERx Renal study delineate the precise origin and evolution of clear cell renal cell carcinoma in minute detail. The insights gained from these studies might provide improved disease prognostics and identify novel therapeutic targets.

      INTRODUCTION

      The cellular origins of angiomyolipoma and other tuberous sclerosis complex-associated neoplasms are unknown. Now, two studies show that these neoplasms derive from cancer stem cells that originate from multipotent renal epithelial cells. The new findings provide a link between stemness and tumorigenesis in the kidney.

      Renal cell carcinoma RCC is the most common malignancy seen in the nephrology clinic, yet most nephrologists have inadequate knowledge of current treatment options. Here we discuss RCC presentation and therapies, including potential renal adverse effects, and highlight the need for involvement of nephrologists in the multidisciplinary management of this disease. Comment 5 Feb Nature Reviews Nephrology.