Abstract
Onco-nephrology is a rapidly growing field that has recently garnered significant attention. Although the risk of developing cancer is reported to be higher in patients with end-stage renal disease (ESRD) than in the general population, the screening protocol and the treatment of cancer in ESRD patients have not yet been established. Recent studies have suggested that cancer screening in dialysis patients would be ineffective from a cost and survival benefit perspective. Nevertheless, the ESRD population is heterogeneous, including patients of varying age and comorbidity, and it is essential to identify those who would benefit from cancer screening. Once patients with ESRD are diagnosed with cancer, anti-cancer treatment should be initiated. However, a treatment strategy has not yet been established. Although many drugs require dose adjustments in hemodialysis patients, data on the pharmacokinetics of anti-cancer agents in these patients remain scarce. This review addresses the recent evidence of cancer risk and screening in the ESRD population and the pharmacokinetics of anti-cancer agents in hemodialysis patients.
Highlights
Onco-nephrology is a new and evolving subspecialty that connects two different areas, oncology and nephrology
This review provided recent evidence for cancer risk and screening in the end-stage renal disease (ESRD) population
There is a pressing need for clinical trials that are designed to identify those who would benefit from cancer screening in this population
Summary
Onco-nephrology is a new and evolving subspecialty that connects two different areas, oncology and nephrology. The presence of benign vascular calcification in women with ESRD complicates mammography and leads to higher rates of false-positive results [45] Since these cancers do not appear to be more common in patients with ESRD, patients on transplant waiting lists and patients with predisposing risk factors and long expected survival would be appropriate candidates for these screenings. A total of 44 % of the treated patients developed iatrogenic toxicity: 34 % related to drugs requiring dosage adjustment and 17 % related to additional drugs with no existing management recommendations in dialysis patients These results indicated that the lack of evidence concerning the use of systemic anti-cancer agents in renal insufficiency could lead to the inappropriate use of chemotherapy and fatal toxic effects in these patients. HD was performed 1 h after the administration of oxaliplatin on day 1 and was repeated 2 days later after the completion of
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