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2016 ; 29
(2
): 143-152
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Glomerular diseases and cancer: evaluation of underlying malignancy
#MMPMID26498294
Pani A
; Porta C
; Cosmai L
; Melis P
; Floris M
; Piras D
; Gallieni M
; Rosner M
; Ponticelli C
J Nephrol
2016[Apr]; 29
(2
): 143-152
PMID26498294
show ga
Onconephrology is an emerging medical subspecialty focused on the numerous
interconnections between cancer and kidney diseases. Patient with malignancies
commonly experience kidney problems including acute kidney injury, tumor lysis
syndrome, fluid and electrolyte disorders and chronic kidney disease, often as a
consequence of the anti-cancer treatment. Conversely, a number of
glomerulopathies, tubulopathies and vascular renal diseases can early signal the
presence of an underlying cancer. Furthermore, the administration of
immunosuppressive drugs, especially cytotoxic drugs and calcineurin inhibitors,
may strongly impair the immune response increasing the risk of cancer. The
objective of this review article is to: (i) discuss paraneoplastic glomerular
disease, (ii) review cancer as an adverse effect of immunosuppressive agents used
to treat glomerulopathies, and (iii) in the absence of international approved
guidelines, propose a screening program based on expert opinion aimed at guiding
nephrologists to early detect malignancies during their clinical practice.
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