Abstract: FR-PO289
One-Year Experiences of an Onconephrology Outpatient Clinic in New York
Session Information
- Onconephrology: From AKI to CKD and Everything in Between
November 03, 2023 | Location: Exhibit Hall, Pennsylvania Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Maheshwari, Rahul, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Abramson, Matthew, Icahn School of Medicine at Mount Sinai, New York, New York, United States
- Deshpande, Priya, Icahn School of Medicine at Mount Sinai, New York, New York, United States
Background
Onconephrology is an emerging field within nephrology, as novel treatments in oncology have unique implications for kidney disease and care. Consequently, dedicated onconephrology clinics have been established to facilitate interdisciplinary care. However, there are no descriptions of actual onconephrology clinic experiences in the US. We report our patient characteristics during the first year of our onconephrology clinic.
Methods
The onconephrology clinic operates one half-day per week since December 2021 and is staffed by two nephrologists. We performed retrospective chart reviews of all patients seen in the first 12 months of operation, collecting patient characteristics, referral indications, primary malignancy, and referral information.
Results
88 patients were seen with a mean age of 65.4 years, and 52% were male. The average GFR at initial visit was 44 mL/min. CKD stage at the time of initial visit was 3% CKD I, 20% CKD II, 15% CKD IIIa, 30% CKD IIIb, 26% CKD IV, and 6% CKD V (albuminuria data not reliably available at initial visit). Patients had 25 distinct primary malignancies; the most common were 35% multiple myeloma, 13% MGUS, and 13% lung cancer. 74% of referred patients had CKD. Other reasons for referral included 28% AKI, 15% proteinuria, 7% hyperkalemia, 6% TMA, 5% hyponatremia, 2% hypomagnesemia, and 1% hypertension, referred by 45 distinct providers. Median time from referral to consult for non-CKD referrals was 19 days (IQR 11-43). 40% of patients had Medicaid insurance. 15% of patients seen underwent a kidney biopsy.
Conclusion
Our experiences with an onconephrology outpatient clinic in New York highlight the diverse patient population and range of kidney-related issues encountered in this setting. The majority of referrals were for CKD, with multiple myeloma as the most common malignancy. These findings underscore the importance of collaboration between oncology and nephrology specialists to provide optimal care for patients with cancer-related kidney diseases. Further studies may provide insight into the long-term outcomes and best practices for managing these complex patients.
Current and future areas of inquiry for onconephrology clinics