Onko-nefrologija
Onco-nephrology

Authors

  • Tomaž Milanez Institute of Oncology Ljubljana; University Medical Centre Ljubljana
  • Janja Ocvirk Institute of Oncology Ljubljana
  • Miha Arnol UKC Ljubljana

DOI:

https://doi.org/10.25670/oi2021-005on

Keywords:

onco-nephrology, estimation of renal function, nephrotoxicity, chronic kidney disease, kidney cancer, kidney transplantation

Abstract

Onko-nefrologija je novo, multidisciplinarno področje, ki povezuje predvsem področji onkologije in nefrologije. Število bolnikov z rakom, ki imajo različno stopnjo ledvične okvare, narašča. Cilj celostne obravnave onko-nefrološkega bolnika je večja učinkovitost in varnost zdravljenja. Bolniki z ledvično okvaro višje stopnje so bili izključeni iz prospektivnih randomiziranih raziskav, tako da za njih ni na voljo podatkov z visoko dokazi visoke stopnje o učinkovitosti in varnosti zdravil ter mejnih vrednostih biooznačevalcev, ki so v pomoč pri vodenju zdravljenja. V klinični praksi se zato pri zdravljenju onko-nefrološkega bolnika opiramo na klinične izkušnje, podatke iz retrospektivnih analiz in posameznih objavljenih primerov ter priporočila, ki temeljijo na soglasju strokovnjakov. Pri zdravljenju onko-nefrološkega bolnika je ključno tesno sodelovanje med onkologom in nefrologom, mnogokrat je nujen multidisciplinarni posvet. Zdravnik, ki je odgovoren za načrt zdravljenja, potrebuje osnovno znanje nefrologije in dobro poznavanje omejitev onkološkega zdravljenja. Zaradi vedno večjega števila onko-nefroloških bolnikov in novih možnosti protirakavega zdravljenja je pred desetimi leti na Onkološkem inštitutu Ljubljana začela delovati onko-nefrološka ambulanta, za zahtevnejše bolnike, ki potrebujejo dodatno multidisciplinarno obravnavo, pa deluje onko-nefrološki konzilij. Delovna skupina za onko-nefrologijo v okviru Sekcije za internistično onkologijo vsako leto pripravi onko-nefrološko šolo, kjer svoj pogled na isti klinični problem predstavijo različni strokovnjaki. Ena izmed prioritet onko-nefrologije so raziskave. V prispevku so opisane pomembnejše teme s področja onko-nefrologije skupaj z izzivi iz klinične prakse.


Abstract (Eng)

Onco-nephrology is a new, multidisciplinary field, which connects the fields of oncology and nephrology. The number of cancer patients with various stages of kidney disease has been increasing. The goal of the holistic management of onco-nephrologic patient is to increase efficacy and safety of treatment. Since patients with renal impairment have been excluded from prospective randomized trials, for these patients there is no available data with high level of evidence about efficacy and safety of treatment and the limit values of biomarkers, which help to guide the treatment. In clinical practice, the management of onco-nephrologic patient is based on clinical experience, data from retrospective analyses and case reports, and recommendations supported by the expert consensus. Close cooperation between an oncologist and nephrologist is crucial and a multidisciplinary consultation is often needed. The physician who is responsible for the treatment plan needs to have a basic knowledge of nephrology and a good knowledge of limitations of oncologic treatment. Due to an increasing number of onco-nephrologic patients and new anti-cancer treatment options, an onco-nephrology outpatient clinic started to operate at the Institute of Oncology Ljubljana ten years ago. A medical council has been established for more complex patients who need additional multidisciplinary care. Every year, The Working Group on Onco-Nephrology of the Section of Medical Oncology organize the Onco-nephrology school, where the views from various experts on a certain clinical problem are presented. One of the priorities of onco-nephrology is research. The paper describes the important topics in the field of onco-nephrology together with challenges from the clinical practice.

Published

2021-05-20

How to Cite

Milanez, T., Ocvirk, J., & Arnol, M. (2021). Onco-nephrology. Onkologija : A Medical-Scientific Journal, 25(1), 48–59. https://doi.org/10.25670/oi2021-005on

Issue

Section

Review Article