Onconephrology and Renal Function in Cancer Treatment
Summary
Onconephrology sits at the intersection of oncology and nephrology, examining how malignancy and its therapies affect kidney function and, conversely, how renal impairment influences cancer treatment. The field addresses the management of tumour-related renal complications, optimisation of chemotherapeutic dosing in the setting of variable glomerular filtration, and surveillance for nephrotoxicity. Haematological and solid tumour therapies often carry a narrow therapeutic index, requiring precise estimation of kidney function to balance efficacy against toxicity. Practical applications span from body-surface-area-adjusted drug regimens in paediatric oncology to algorithm-driven dose adaptations in adults with chronic kidney disease. Global studies have illuminated disparities in kidney dysfunction prevalence among cancer populations, highlighting the need for multidisciplinary cancer care teams including nephrology expertise to improve outcomes.
Research from Nature Portfolio
Recent analyses have rigorously compared formulas for estimated glomerular filtration rate in patients undergoing anticancer therapy. One foundational study demonstrated that the body-surface-area-unadjusted Chronic Kidney Disease Epidemiology Collaboration equation exhibits the least bias and greatest precision in predicting true glomerular filtration rate among cancer patients, suggesting it as a superior tool for therapeutic dosing. Complementing this, investigations into cisplatin therapy have shown that estimated glomerular filtration rate alone is generally sufficient for assessing renal function prior to drug administration, reducing reliance on cumbersome 24-hour urine collections without compromising patient safety.
Onconephrology and Renal Function in Cancer Treatment publication trend
The graph below shows the total number of articles in onconephrology and renal function in cancer treatment across all publications each year (not limited to Nature Index journals).
Technical terms
Onconephrology: The subspecialty addressing the interplay between kidney function and cancer diagnosis, treatment and outcomes.
Glomerular Filtration Rate (GFR): A measure of how efficiently the kidneys filter blood, expressed in millilitres per minute per 1.73 m².
Estimated GFR (eGFR): Renal function calculated from serum biomarkers and demographic variables, used to guide drug dosing.
Area Under the Curve (AUC): A pharmacokinetic metric indicating total drug exposure over time, critical for chemotherapeutic dosing like carboplatin.
End-Stage Renal Disease (ESRD): The final, irreversible stage of chronic kidney disease requiring dialysis or transplantation.
References
- Generation of evidence-based carboplatin dosing guidelines for neonates and infants. British Journal of Cancer (2023).
- Agreement and Precision Analyses of Various Estimated Glomerular Filtration Rate Formulae in Cancer Patients. Scientific Reports (2019).
- Estimation versus measurement of the glomerular filtration rate for kidney function assessment in patients with cancer undergoing cisplatin-based chemotherapy. Scientific Reports (2020).
- Chronic kidney disease in cancer patients, the analysis of a large oncology database from Eastern Europe. PLOS ONE (2022).
- The association of body mass index with safety and effectiveness of first-line carboplatin-based chemotherapy in patients with metastatic non-small cell lung cancer. Cancer Treatment and Research Communications (2022).
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