Abstract
Introduction
Renal events are common in cancer patients and malignancy is a prevalent complication in both patients transplanted and under kidney replacement therapy (KRT). In recent years, onco-nephrology has been developed as a subspecialty whose scope has not been well established yet. The aim of our study was to assess resident and senior physicians’ knowledge and expectations about onco-nephrology.
Methods and Materials
Two anonymous self-administered online questionnaires were developed by a multidisciplinary team and distributed to French residents and senior physicians.
Results
Two hundred twenty-eight physicians answered the survey, including 128 (56%) nephrologists, of which 98 (43%) were senior physicians and 130 (57%) were residents. Nephrologists rated their confidence in their ability to face onco-nephrological situation at 6/10 (interquartile range (IQR) 4.0–7.0) and oncologists at 6.0/10 (5.0–7.0). Managing cancer drugs in patients on KRT or in transplanted patients and discussion about introducing dialysis in cancer patients were designated as the most challenging topics. Asking if they had received appropriate learning, residents’ median agreement was ranked at 3.0/10 (2.0–4.0). Forty-six percent of the respondents considered available resources as not appropriate. Specialized onco-nephrology consultations were accessible for 21% of the respondents. Finally, respondents thought there is a strong need for a national working group (8.3/10) with 87% of them expecting new reliable guidelines.
Conclusion
The present survey revealed physicians’ expectations about onco-nephrology implementation in France. An appropriate answer could be the creation of a national working group. Therefore, GRIFON (Groupe de Recherche Interdisciplinaire en OncoNéphrologie) has recently been created.
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References
Rosner MH, Perazella MA (2017) Acute kidney injury in patients with cancer. N Engl J Med 376(18):1770–1781. https://doi.org/10.1056/NEJMra1613984 (PMID: 28467867)
Kithlu A, McArthur E, Amir E et al (2019) Acute kidney injury in patients receiving systemic treatment for cancer : a population-based cohort study. J Natl Inst 111(7):727–736
Kemlin D, Biard L, Kerhuel L et al (2018) Acute kidney injury in critically ill patients with solid tumors. Nephrol dial Transplant 33:1997–2005
Vacher VL, Oudard S, Janus N et al (2007) Prevalence of renal insufficiency in cancer patients and implications for anticancer drug management: the Renal Insufficiency and AntiCancer Medication (IRMA) study. Cancer 110:1376–1384
Izzedine H, Mateus C, Boutros C et al (2017) Renal effects of immune checkpoint inhibitors. Nephrol Dial Transplant 32(6):936–942. https://doi.org/10.1093/ndt/gfw382 (PMID: 28025384)
Launay-Vacher V, Aapro M, DeCastroJr G et al (2015) Renal effects of molecular targeted therapies in oncology: a review by the Cancer and the Kidney International Network (C-KIN). Ann Oncol 26(8):1677–1684. https://doi.org/10.1093/annonc/mdv136 (Epub 2015 Mar 3 PMID: 25735315)
GBD 2015 DALYs and HALE Collaborators. Global, regional, and national disability-adjusted life-years (DALYs) for 315 diseases and injuries and healthy life expectancy (HALE), 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016 Oct 8;388(10053):1603–1658. https://doi.org/10.1016/S0140-6736(16)31460-X.
Hill NR, Fatoba ST, Oke JL et al (2016) Global prevalence of chronic kidney disease - a systematic review and meta-analysis. PLoS ONE 11(7):e0158765. https://doi.org/10.1371/journal.pone.015876
Wolfe RA, Ashby VB, Milford EL et al (1999) Comparison of mortality in all patients on dialysis patients on dialysis awaiting transplantation, and recipients of a first cadaveric transplant. N Engl J Med 341(23):1725–30
Janus N, Launay-Vacher V, Ferrero JM et al (2012) Risk of cancer in patients following chronic dialysis and kidney graft. Bull Cancer 99(3):285–93. https://doi.org/10.1684/bdc.2012.1545
Guillemin A, Rousseau B, Neuzillet C et al (2017) De novo cancer after solid organ transplantation: epidemiology, prognosis and management. Bull Cancer 104(3):245–257
Izzedine H, Perazella MA (2015) Onco-nephrology: an appraisal of the cancer and chronic kidney disease links. Nephrol Dial Transplant 30(12):1979–1988
Cosmai L, Porta C, Gallieni M et al (2016) Onco-nephrology: a decalogue. Nephrol Dial Transplant 31(4):515–519
Capasso A, Benigni A, Capitanio U et al (2019) Summary of the International Conference on Onco-Nephrology: an emerging field in medicine. Kidney Int 96(3):555–67
Cosmai L, Porta C, Foramitti M et al (2020) The basics of onco-nephrology in the renal clinic. JNephrol 33:1143–1149
Arnold M, Rutherford MJ, Bardot A et al (2019) Progress in cancer survival, mortality, and incidence in seven high-income countries 1995–2014 (ICBP SURVMARK-2): a population-based study. Lancet Oncol 20(11):1493–1505. https://doi.org/10.1016/S1470-2045(19)30456-5
Sundquist M, Brudin L, Tejler G (2017) Improved survival in metastatic breast cancer 1985–2016. Breast 31:46–50. https://doi.org/10.1016/j.breast.2016.10.005
Canet E, Zafrani L, Lambert J et al (2013) Acute kidney injury in patients with newly diagnosed high-2grade hematological malignancies: impact on remission and survival. PLoS ONE 8(2):e55870
GRIFON website (in French): https://assogrifon.webnode.fr/
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Delaye, M., Try, M., Rousseau, A. et al. Onco-nephrology: Physicians’ Expectations About a New Subspecialty. J Canc Educ 38, 878–884 (2023). https://doi.org/10.1007/s13187-022-02201-8
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DOI: https://doi.org/10.1007/s13187-022-02201-8