Glomerular diseases and cancer: evaluation of underlying malignancy

• Published in: Journal of nephrology Vol. 29; no. 2; pp. 143 - 152
• Main Authors: Pani, Antonello, Porta, Camillo, Cosmai, Laura, Melis, Patrizia, Floris, Matteo, Piras, Doloretta, Gallieni, Maurizio, Rosner, Mitchell, Ponticelli, Claudio
• Format: Journal Article
• Language: English
• Published: Cham Springer International Publishing 01-04-2016
• Subjects: Antineoplastic Agents - adverse effects; Glomerulonephritis - diagnosis; Glomerulonephritis - drug therapy; Glomerulonephritis - epidemiology; Glomerulonephritis - immunology; Humans; Immunocompromised Host; Immunosuppressive Agents - adverse effects; Medical Oncology; Medicine; Medicine & Public Health; Neoplasms - chemically induced; Neoplasms - diagnosis; Neoplasms - drug therapy; Neoplasms - epidemiology; Neoplasms - immunology; Nephrology; Paraneoplastic Syndromes - diagnosis; Paraneoplastic Syndromes - epidemiology; Paraneoplastic Syndromes - therapy; Review; Risk Assessment; Risk Factors; Urology; Glomerular diseases; Onconephrology; Nephrotic syndrome; Immunosuppressive therapy; Membranous nephropathy; Cancer
• ISSN: 1121-8428; 1724-6059
• DOI: 10.1007/s40620-015-0234-9

Onconephrology is an emerging medical subspecialty focused on the numerous interconnections between cancer and kidney diseases. Patient with malignancies commonly experience kidney problems including acute kidney injury, tumor lysis syndrome, fluid and electrolyte disorders and chronic kidney disease, often as a consequence of the anti-cancer treatment. Conversely, a number of glomerulopathies, tubulopathies and vascular renal diseases can early signal the presence of an underlying cancer. Furthermore, the administration of immunosuppressive drugs, especially cytotoxic drugs and calcineurin inhibitors, may strongly impair the immune response increasing the risk of cancer. The objective of this review article is to: (i) discuss paraneoplastic glomerular disease, (ii) review cancer as an adverse effect of immunosuppressive agents used to treat glomerulopathies, and (iii) in the absence of international approved guidelines, propose a screening program based on expert opinion aimed at guiding nephrologists to early detect malignancies during their clinical practice.