#4281 TERTIARY HOSPITAL EXPERIENCE IN AN ESSENTIAL SUBSPECIALTY: ONCONEPHROLOGY

Abstract

Abstract Background and Aims Kidney complications of cancer patients and cancer in renal patients have increased in recent years. The objective of this study is to evaluate the characteristics of the patients referred to the Onconephrology Unit from January 2021 to December 2021, studying the cognitive and mood status of these patients. Method This is a prospective observational study of the Onconephrology consultation at a University Hospital Center during 2021. Clinical and analytical characteristics of the patients and clinical indication for referral were analyzed. In addition, sleep quality, mood and cognitive status were assessed using validated rating scales (Epsworth, Geriatric Depression Scale and Montreal). Results Seventy-four patients were evaluated, mean age was 69.6(±11) years, 41(55.4%) men, 47(63.5%) had hypertension, 18(24.3%) diabetics, and 11(14.9%) were affected by heart disease. In addition, creatinine 1.93(±1.1)mg/dl, eGFR 39.97(±20.3)mL/min, proteinuria 187[29-515.9]mg/g, and 4(5.4%) had microhematuria. The most frequent cancers were intestinal, gynecological and mammary with 12.16% (n = 9) each. 58.3% (n = 42) of patients had metastatic disease. 48.7%(n = 36) received chemotherapy and 58.1%(n = 43) targeted therapies. Platinum was the most frequently used chemotherapy and anti-VEGF in terms of targeted therapies, followed by tyrosine kinase inhibitors, anti-PD1 and anti-PDL1. The most frequent clinical indication for referral was acute renal failure (n = 36;48.7%) followed by chronic kidney disease (n = 27;36.49%) and proteinuria (n = 5;6.76%). Rating scales were obtained in 51 patients: 49% (n = 25) were snorers, followed by 17.6% (n = 9) with insomnia and 11.8% (n = 6) with OSAS. 27 patients (36.5%) had cognitive impairment. Mild depression was detected in 13 cases (25.5%) and moderate depression in 11.6% (n = 6). 21 renal biopsies were performed, the most frequent diagnosis was acute interstitial nephritis (71.4%, n = 15) followed by thrombotic microangiopathy (19% n = 4). A total of 15 patients (20.3%) died during the year. Conclusion Most patients referred to Onconephrology are affected by advanced oncological disease and consequently had a high mortality. The most frequent indication for referral was acute kidney injury (48.7%). Comprehensive patient care is important, given the prevalence of depressive syndrome. Onconephrology is an example of a comprehensive and multidisciplinary approach to improve the survival and quality of life of patients with advanced cancer and renal disease.