Ambulatory onconephrology and palliative care: foundations for a clinical protocol
Keywords:
CUIDADOS PALIATIVOS INTEGRATIVOS; INSUFICIENCIA RENAL CRÓNICA; LESIÓN RENAL AGUDA; ONCOLOGÍA MÉDICA.; INTEGRATIVE PALLIATIVE CARE; RENAL INSUFFICIENCY, CHRONIC; ACUTE KIDNEY INJURY; MEDICAL ONCOLOGY.; CUIDADOS PALIATIVOS INTEGRATIVOS; INSUFICIÊNCIA RENAL CRÔNICA; INJÚRIA RENAL AGUDA; ONCOLOGIA.Abstract
Introduction: onconephrology has emerged as a critical subspecialty at the intersection of nephrology and oncology, responding to the growing prevalence of kidney disease in cancer patients.
Objective: to assess classical and contemporary evidence in order to provide epistemological and clinical foundations for an outpatient care protocol, taking into consideration palliative care for patients with cancer and kidney disease.
Methods: a narrative review of the scientific literature was conducted across various databases. The search was carried out using an algorithm with keywords and Boolean operators, allowing for the identification of relevant sources. The selected studies, after applying inclusion and exclusion criteria, were critically analyzed considering currency, methodological quality, and thematic relevance, and were integrated into the final synthesis of the review.
Development: the main global and regional trends in the study of this subject were analyzed: epidemiological characterization, pathophysiological bases of oncological nephrotoxicity, the institutional evolution of onconephrology, the challenges of chemotherapy dosing in the context of chronic kidney disease, specific electrolyte syndromes, and Latin American particularities regarding access, inequity, and training. It is noted that, from this perspective, palliative care has as one of its primary objectives providing maximum comfort to the patient.
Conclusions: outpatient onconephrological care in which palliative care is integrated in a structured manner, and supported by multidisciplinary protocols, is necessary, feasible, and urgent, especially in resource-limited settings.
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Copyright (c) 2026 Jennifer Martínez Iglesias, Pedro Carlos Crespo Carrera, Dayanis Montero Hernández , Maria de la Caridad Casanova Moreno
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