Focused Care for Cancer Patients with Kidney Disease at the UPMC Kidney Disease Center

The UPMC Kidney Disease Center provides care for every kidney disease, with specialized programs for the treatment of glomerular disorders, electrolyte disorders, and complex hypertension. The center now provides focused care for patients with kidney disease who also have a cancer diagnosis, under the direction of Chris Passero, MD, and Hunter Huston, MD, at UPMC Shadyside. 

Cancer and the Kidney are Inherently and Complexly Related   

Whether its renal cell carcinoma or a malignancy involving another organ in the body, cancer and cancer treatment inherently affect and involve the kidney. In recent years, novel anti-cancer drugs have entered clinical practice at an incredibly fast pace, and many of these new drugs have complicated effects on the kidneys. Even at the level of etiology, teasing apart causes like dehydration from the effects of cancers and the chemotherapy agents themselves has become increasingly complex. 

Treatment for kidney disease with a background of cancer requires specialists who dedicate their time to: 

• Reviewing the latest research about how various malignancies affect the kidneys
• Tracking the development of novel anti-cancer agents and their side affects 
• Understanding how typical treatments for kidney disease may impact cancer patients differently 
• Identifying the cause of kidney injury in the patient, causes that are likely to be multi-directional and nonlinear 

These complexities demand the attention of a subspecialty approach. 

Working in collaboration with oncologists, intensivists, and palliative care specialists, our experts are now providing this focused, subspecialty care. Our onconephrologists guide oncologists and patients and their families through the treatment process to preserve kidney function while the patient focuses on overcoming their cancer. 

Onconephrology Care is Life-Long 

At UPMC, we recognize an increasing need for nephrologists who focus on care for patients who have a cancer diagnosis, are being treated for cancer, or who have overcome their cancer. Chronic kidney disease has already been established as a common complication of cancer treatment, and now, given the incredible success of novel treatment modalities, patients are surviving their cancers at higher rates and many of these patients will require ongoing onconephrology care. 

Even among the larger population, kidney disease becomes more common as patients age. At UPMC, we expect that cancer survivors, as they age, will be just as likely to experience kidney disease or electrolyte disturbances. But managing care for this patient population will be made more complex by their medical history and the potential for recurrence. 

An onconephrologist is best suited to provide this care, which requires a complex understanding of how a former cancer patient may tolerate or react to typical renal treatments in different ways and a readiness to act to preserve kidney function during instances of cancer recurrence. These patients may require life-long care from a subspecialty nephrologist. 

To provide this long-term specialty treatment, UPMC is investing in the future of onconephrology.  

Training the Next Generation of Onconephrologists 

The existing Renal-Electrolyte Fellowship Program at UPMC provides a typical two-year structured curriculum, though with a relatively large sized training program we are able to offer additional training as a third year to those fellows seeking further specialization. 

To meet the goal of providing long-term renal care for cancer patients at UPMC, we are developing an advanced onconephrology training program for clinicians who want to dedicate their careers to the intersection of cancer and the kidney. 

The mission of this program being to master the understanding and management of the following:  

• Various kidney complications related to cancer, including acute kidney injury, chronic kidney disease, and electrolyte disorders
• Strategies for researching the effects of novel cancer therapies on the kidneys
• Optimizing traditional treatments for renal disorders against the complex background of cancer diagnosis 

To learn more about nephrology care at UPMC, visit UPMCPhysicianResources.com/Kidney.