Onconephrology

Abstract

Pediatric oncology patients are at risk for both acute and chronic kidney injury, not only from the cancer itself, but often related to its treatment. Chemotherapy, radiation, medications, infections, hematopoietic stem cell transplant, and newer therapies like CAR-T cells and immune checkpoint inhibitors are beneficial in treating this at-risk population, but also contribute to the risk of kidney injury. Treatment advances in oncology have markedly improved outcomes, with these advances leading to a greater incidence and prevalence of kidney disease in cancer patients. This chapter addresses major nephrology issues affecting the pediatric cancer patient, focusing on acute and chronic management of kidney dysfunction. Within these realms, specific attention is given to kidney injury due to (1) primary oncologic disease, (2) established and emerging treatments, and (3) hematopoietic stem cell transplant. This chapter provides a foundation for the approach to patients that are within the realm of onconephrology, an evolving and expanding field.