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Onconephrology : ウィキペディア英語版
Onconephrology
Onconephrology (from the Ancient Greek onkos (ὄγκος) meaning bulk, mass, or tumor, nephros (νεφρός) meaning kidney, and the suffix -logy (-λογία), meaning "study of") is a burgeoning new specialty in nephrology that deals with the study of kidney diseases in cancer patients.

A nephrologist who takes care of patients with cancer is called an onco-nephrologist. This branch of nephrology encompasses both the hematologic and oncology based cancers and their treatment related complications that deal with the kidney. Unlike general nephrology, there are several aspects of onconephrology that are unique. Kidney failure from break down of cancer cells, usually after chemotherapy, is unique to onconephrology. The Syndrome of Inappropriate Anti Diuretic Hormone (SIADH) that causes low serum sodium concentration and first described in lung cancer patients is common in cancer patients. Kidney diseases that are unique to bone marrow transplant (aka Stem Cell Transplant or SCT) are frequently seen in cancer patients. Fluid, electrolytes and acid base disturbances are much more common and often severe in cancer patients, especially in those who receive chemotherapy. Several chemotherapeutic agents – for example cisplatin – are associated with acute and chronic kidney injuries. Newer agents such as anti Vascular Endothelial Growth Factor (anti VEGF) are also associated with similar injuries, as well as proteinuria, hypertension and thrombotic microangiopathy.
The most common form of kidney disease in cancer patients is acute kidney injury (AKI) which can usually be due to volume depletion from vomiting and diarrhea that occur following chemotherapy or occasionally due to kidney toxicities of chemotherapeutic agents. Less frequently AKI can occur due to obstruction to urine flow from tumor or lymph node enlargement. Also, cancer cells by infiltrating the kidney or myeloma proteins by precipitating with in the tubules of the kidney can cause kidney injury.
Cancer management has become comprehensive and multidisciplinary, and often an onconephrologist is included in major centers to address and advice on kidney problems in cancer patients.
Topics that are usually of interest to onco-nephrologists are:
1. Electrolyte disorders of malignancy
2. Secondary Glomerular diseases of malignancy
3. Cancer related renal complications
4. Chemotherapy related renal complications
5. Myeloma Nephrology
6. Amyloidosis Nephrology
7. Thrombotic Microangiopathy and all its causes and treatment strategies( HUS/TTP)
8. Bone marrow transplant related kidney diseases
9. Radiation Nephropathy
10. Tumor Lysis Syndrome
11. Acute Kidney injury in the hospitalized cancer patient.
12. The ethics of dialysis in the dying cancer patient
13. Dialysis and chemotherapy agents
14. Tumor invasion of the kidney
15. Obstructive renal disease
16. Chronic Kidney disease after chemotherapy induced AKI
17. Renal cell cancer
18. CKD following nephrectomy
Centers in the United States and other countries have started forming onconephrology-related patient approach. At (Brigham and Women's hospital( Harvard University) ), the Urology, Nephrology and oncology teams that are involved in the care of the renal cell cancer patient have developed a center of onco-nephrology expertise. A similar approach as been taken at the (North Shore LIJ Cancer institute kidney cancer section ).
Two textbooks have been written on this topic. Onconephrology: cancer, chemotherapy and the kidney by Jhaveri et al by Springer () and Cancer and the Kidney by Eric Cohen by Oxford Univ Press ()

In addition, the (American Society of Nephrology ) formed the first ever Onconephrology Forum (ONF) focusing on onconephrology at national levels.
==References==


抄文引用元・出典: フリー百科事典『 ウィキペディア(Wikipedia)
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