Cardiovascular and Renal Risk Stratification in Patients Referred to an Onconephrology Clinic and Undergoing Different Oncology Therapies: A Real-World Study

Q: What is the clinical evidence from this study?

Study design: Observational. Population: Cancer with concurrent risk of renal and cardiovascular complications (n=83). Intervention: Oncological therapies and associated clinical risk factors. Primary outcome: Incidence of new Acute Kidney Injury (AKI) during follow-up.

Q: What does this research mean for the field?

Patients referred to onconephrology clinics exhibit a high burden of coexisting renal disease and cardiovascular risk, with nearly all patients classified as having high or very high cardiovascular risk. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

Silvia Lai; Adolfo Marco Perrotta; Giovanni Pintus; Paolo Mené; Paolo Izzo; Sara Izzo; Lida Tartaglione; Luciano Izzo; Silverio Rotondi; Francesca Tinti; Luca Salomone; Anna Paola Mitterhofer; Simone Scagnoli; Andrea Botticelli; Daniele Santini; Giuseppe Ciniero; A Punzo; Gianluigi Zaza

doi:10.3390/biomedicines14061342

Key result

New AKI affects ~18% of high-cardiovascular-risk onconephrology patients over 12 months.

n=83

Figures

Why the study?

Kidney disease and cardiovascular risk frequently coexist in cancer patients and may significantly affect oncological outcomes.

Key Points

To evaluate cardiovascular and renal risk stratification, renal outcomes, and mortality in cancer patients undergoing antineoplastic therapies who were referred to an onconephrology clinic.
Single-center, prospective, observational study enrolling adult oncological patients (N=83; mean age 69.8 ± 11.6 years; 60.2% male) with follow-up evaluations at baseline and after 1, 3, and 12 months.
Assessed renal endpoints including acute kidney injury (AKI), chronic kidney disease (CKD), and major adverse kidney events (MAKEs), alongside cardiovascular risk scoring using the SCORE system.
At baseline, 96.7% of patients were categorized as high (63.9%) or very high (32.8%) cardiovascular risk, while AKI was present in 30.4%, CKD in 27.8%, and AKI on CKD in 16.5%.
During follow-up, 18.1% of patients developed new-onset AKI, and MAKEs occurred in 30.4% of the cohort, predominantly driven by oncological mortality (18.1% of total patients).
Male sex was confirmed as the sole significant independent predictor of mortality in Cox regression analysis (p=0.029), with baseline AKI correlating with MAKEs in patients receiving immune checkpoint inhibitors (p=0.037).

Study Design

Type

Observational (n=83)

Multicenter

No

Structured PICO

P

Population

83 adult onconephrology patients with a high baseline cardiovascular risk, followed over 12 months to evaluate renal and cardiovascular outcomes.

O

Outcome

Incidence of Acute Kidney Injury (AKI)surrogate

Oncology patients referred for nephrology evaluation demonstrate a high burden of acute kidney injury, chronic kidney disease, and elevated cardiovascular risk, underscoring the need for integrated, multidisciplinary onconephrology and cardiovascular care.

Limitations

Small sample size making results difficult to generalize
Observational, single-center study design raising the possibility of confounding by indication
Cardiovascular events were not systematically recorded, precluding assessment of cardiovascular outcomes
MAKEs endpoint largely affected by cancer-related mortality
12-month follow-up period may not be sufficient to fully capture long-term renal and cardiovascular outcomes
Small sample size in a highly selected single-center population
Observational study design with baseline clinical imbalances precludes causal inference regarding treatment effects
Cardiovascular events were not systematically recorded
12-month follow-up period may be insufficient to fully capture long-term outcomes
Lack of histological data to evaluate paraneoplastic mechanisms of renal involvement

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Implication

Elevated new-AKI rates in high-CV-risk onconephrology patients may warrant closer monitoring; leaves open optimal preventive strategies.

Abstract

Background: Onconephrology is an emerging field addressing renal and cardiovascular complications in patients with cancer. Kidney disease and cardiovascular risk frequently coexist and may significantly affect oncological outcomes. Methods: We conducted a single-center, prospective, observational study including adult oncological patients. Patients were evaluated at baseline and after 1, 3, and 12 months. Renal outcomes (Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD), AKI on CKD, Acute Kidney Disease (AKD)), cardiovascular risk assessment scores (using the SCORE/SCORE2 systems), and major adverse kidney events (MAKEs) were recorded. Results: Eighty-three patients were enrolled (mean age 69.8 ± 11.6 years, 60.2% male). At baseline, AKI was present in 30.4%, CKD in 27.8%, and AKI on CKD in 16.5% of patients. Overall, 96.7% of the cohort was classified as having a high or very high cardiovascular risk. During follow-up, 18.1% experienced new AKI, and MAKEs occurred in 30.4% of patients, driven primarily by mortality. Male sex emerged as the main predictor of death. Conclusions: Onconephrology patients suffer from a high burden of renal disease and cardiovascular risk. Integrated nephrological and cardiovascular assessment may represent a key component of personalized cancer care.

Discussion

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Cite This Study

Lai et al. (2026) conducted an observational in Cancer with concurrent risk of renal and cardiovascular complications (n=83). Oncological therapies and associated clinical risk factors was evaluated on Incidence of new Acute Kidney Injury (AKI) during follow-up. During a 12-month follow-up, 18.1% of adult onconephrology patients experienced a new acute kidney injury episode in a cohort where 96.7% had high or very high baseline cardiovascular risk.

synapsesocial.com/papers/6a314f3f430f791681c82d76 https://doi.org/10.3390/biomedicines14061342

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Cardiovascular and Renal Risk Stratification in Patients Referred to an Onconephrology Clinic and Undergoing Different Oncology Therapies: A Real-World Study

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Cardiovascular and Renal Risk Stratification in Patients Referred to an Onconephrology Clinic and Undergoing Different Oncology Therapies: A Real-World Study

Figures

Key Points

Study Design

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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