Expert Kidney Care During Cancer Treatment
Onconephrology Clinic
Our clinic is open to patients who are currently getting treatment at Fred Hutch for any type of cancer.
Please talk with your Fred Hutch care team to find out if a referral to the Onconephrology Clinic might be right for you. Telehealth (virtual) and in-person appointments are available.
People with cancer sometimes develop new kidney problems related to their cancer or its treatment. Others already have a kidney condition that might worsen or change once they start cancer care. In both cases, it’s important to have a kidney specialist (an onconephrologist) who understands cancer and the therapies used to control it.
At Fred Hutch Cancer Center, you have access to this type of specialized care through our Onconephrology Clinic.
What is the Onconephrology Clinic?
The Onconephrology Clinic team diagnoses and treats kidney conditions in people getting cancer care at Fred Hutch. Our focus is helping people who have new and pressing (acute) kidney problems along with active cancer. We also see people before or after a blood or marrow transplant if there is a question about their kidney function or how to manage their kidney health during the transplant process.
The clinic is led by onconephrologist A. Bilal Malik, MBBS. He and his team see a large number of people going through cancer treatment. They know how a wide range of cancers and cancer therapies can affect your kidneys. Working closely with the rest of your Fred Hutch care team, they can recommend care that matches your complex needs.
If you have chronic kidney disease from causes other than cancer or its treatment, or if your cancer is stable and you have kidney concerns from cancer treatment you received in the past, UW Medicine offers expert care through its general nephrology clinics.
What can the clinic help me with?
We help patients with a range of issues, including:
Kidney Problems from Cancer Medicines
Some chemotherapies and immunotherapies may lead to problems such as:
- Damage to the small tube-like structures (tubules) in the kidneys that collect the fluid that becomes urine.
- Crystals that block the flow of urine.
- Breakdown of tiny blood vessels in the kidneys and formation of small blood clots.
Electrolyte Imbalances
Cancer and cancer treatments can change the levels of minerals (like sodium, magnesium, phosphorus and calcium) in your blood and other body fluids. Normally, the kidneys help to balance these minerals.
Damage to the Kidney Tissues that Filter Blood to Make Urine (Renal Parenchymal Disease)
This can include problems like:
- Tubules blocked or damaged by myeloma proteins or by the breakdown of tumor cells after chemotherapy.
- Loss of kidney tissue from a large or spreading tumor.
- Severe blockage of major tubes that drain urine due to a tumor or enlarged lymph nodes.
- Reduced kidney function after part or all of a kidney is removed to treat kidney cancer.
- Blood cancer that has spread to kidney tissue.
- Impaired kidney function from very high blood pressure or fluid overload (your body is holding onto too much fluid).
Other Cancer-Related Concerns
- Kidney problems from dehydration if cancer treatment affects your food and fluid intake or how much fluid your body absorbs or loses.
- In patients with advanced kidney disease, repeated administration of high doses of contrast agents that contain iodine or gadolinium (used for some types of imaging scans).
- Problems with other organs, like the heart or liver, that can affect how the kidneys work.
What can I expect from my appointment?
At your first visit to the Onconephrology Clinic, you’ll see an onconephrologist. This physician will talk with you about:
- Your medical history
- Your current and past cancer treatments
- Other medicines you take
- Signs or symptoms that might relate to your kidney health
They will also do a physical exam, and they may request lab tests or imaging scans to get more details. Before the end of your visit, the physician will explain what they’ve been able to tell about your kidney health and what steps they recommend next for you, and they’ll answer your questions. They will share information and coordinate any treatment you need with your cancer care team.
Appointments are available both in person at the Fred Hutch Sloan Clinic 1, 3rd floor, or virtually via telehealth. You can expect your first appointment to be 30 to 60 minutes. We’ll schedule any follow-up visits based on your needs and treatment plan.