Nephrology and Hypertension

Mayo Clinic's Onco-Nephrology Clinic evaluates and treats adults who have kidney disease caused by cancer or its treatment. The clinic also cares for people who have existing kidney disease at the time of a cancer diagnosis.

Onco-nephrology is a specialized type of kidney care for people with cancer. Cancer and its treatment can reduce how well the kidneys work. Kidney disease also can affect which cancer treatments are safe and effective.

Mayo Clinic onco-nephrologists and cancer specialists work together to manage both conditions. This team approach helps reduce the risk of kidney damage. It also helps find and treat kidney conditions early, guide safe and effective cancer treatment, and limit side effects so cancer treatment can continue.

The Onco-Nephrology Clinic is available at Mayo Clinic's campuses in Arizona, Florida and Minnesota. Each year, Mayo Clinic kidney specialists care for more than 26,000 people with chronic kidney disease. This experience is part of what makes Mayo Clinic one of the largest and most respected kidney care practices in the world.

How cancer care affects the kidneys

Cancer and cancer treatment can affect the kidneys in several ways:

• Some chemotherapy and immunotherapy medicines can damage the kidneys.
• Cancer and its treatment can lead to dehydration, infection, or rapid breakdown of cancer cells after treatment — called tumor lysis syndrome — which can strain kidney function.

Some people have a higher risk of kidney injury during cancer treatment, including:

• Older adults.
• People with kidney disease before receiving cancer treatment.

Because of these risks, kidney and cancer care often need to be managed together.

When to see an onco-nephrologist

Onco-nephrologists are specialized kidney doctors, known as nephrologists, who focus on managing kidney complications in people with cancer.

You may benefit from care at the Onco-Nephrology Clinic if you:

• Have kidney disease and need cancer treatment.
• Are at higher risk of kidney complications during cancer treatment.
• Develop kidney disease during or after cancer treatment.
• Receive dialysis and need cancer care.
• Have a kidney transplant and are being treated for cancer.

Kidney and cancer care, together

At the Onco-Nephrology Clinic, kidney specialists and cancer specialists work together as one team. They guide care decisions and adjust treatment to protect kidney function, limit side effects and support safe, effective cancer treatment.

Your team may include:

• Onco-nephrologists.
• Cancer specialists, also called oncologists.
• Hematologists.
• Pharmacists.
• Other specialists as needed.

Because your care team works across specialties, your tests and treatment plan are often completed within days.

Care throughout cancer treatment

The Onco-Nephrology Clinic provides care at every stage of cancer treatment to protect your kidney health and help you continue treatment safely.

Before cancer treatment, your care team checks your kidney function, assesses your risk for kidney injury and helps guide safer treatment options.

During cancer treatment, your team assesses how well your kidneys are working and manages kidney-related complications. Treatment is adjusted as needed to protect the kidneys and help limit side effects.

After cancer treatment, your team checks for long-term kidney damage and treats any ongoing kidney conditions. The team also may create a plan to track kidney health over time.

Your team provides guidance on diet, physical activity and long-term kidney health throughout your care.

Comprehensive onco-nephrology care

Mayo Clinic's Onco-Nephrology Clinic provides specialized care for adults who have both cancer and kidney disease.

Services include:

• Evaluating kidney problems related to cancer or its treatment.
• Planning cancer treatment for people with kidney disease or a high risk of kidney complications.
• Treating kidney injury and other kidney-related side effects of cancer treatments.
• Providing dialysis and supportive treatments when needed.
• Managing cancer treatment for people who have had a kidney transplant.
• Monitoring kidney health before, during and after cancer treatment.

Kidney conditions treated

• Acute kidney injury.
• Chronic kidney disease.
• Electrolyte disorders, such as hyponatremia and low potassium (hypokalemia).
• High blood pressure, also called hypertension, caused by cancer therapy.
• Multiple myeloma-related kidney disease.
• Nephrotic syndrome.
• Tumor lysis syndrome.

Research and clinical trials

Mayo Clinic researchers work to understand how cancer therapies affect the kidneys and how to prevent or reduce kidney damage. They study using imaging tests to monitor kidney health and identify the risk of kidney disease before, during and after cancer treatment.

They also study how newer cancer treatments, such as immune checkpoint inhibitors and CAR-T cell therapy, affect the kidneys compared with standard chemotherapy.

You may have the opportunity to take part in a clinical trial at Mayo Clinic. Talk to your care team about whether a clinical trial might be right for you.

Referrals

For patients

You may be referred to the Onco-Nephrology Clinic at Mayo Clinic in Rochester, Minnesota, by your oncologist. You also may schedule an appointment without a referral.

For referring healthcare professionals

Mayo Clinic specialists work closely with referring clinicians to coordinate care. To request a consultation or refer a patient, contact the Referring Physician Service. To refer a patient to the Onco-Nephrology Clinic in Rochester, Minnesota, call 800-533-1564.