As onconephrologists are primarily taking care of kidney disease in cancer patients, there are several aspects that are unique to this practice when compared to general nephrology.
One example, the syndrome of inappropriate antidiuretic hormone (SIADH), a disorder of low serum sodium concentration, was first described in lung cancer and is a common electrolyte disturbance seen in this population.
Examples include, hematological cancers such as monoclonal gammopathies (paraproteinemias), which can have significant kidney implications in the form of cast nephropathy or systemic light chain amyloidosis.
[3] Acute kidney injury (AKI) is a commonly feared complication in cancer patients as it can interrupt life saving therapy and potentially have mortality implications.
[6] One area of substantial interest is the estimation of kidney function in cancer patients, as it has direct impact on chemotherapy dosing, selection, and eligibility for chemotherapeutics.
[7] Overall, a collaborative approach with oncologists and onconephrologists are important in managing CKD and addressing concerns such as renal replacement therapy and transplant in this population.
Large academic centers in the United States and other countries have started forming an onconephrology related patient approach to manage these complex disorders as above.
After general nephrology, one may consider an optional subspecialty training in onconephrology in a few select academic centers that offer the 3rd year track.
Centers that offer this training include Memorial Sloan Kettering, MD Anderson, Northwell Health( Hofstra), Mayo Clinic, and the University of Toronto.