#565 Renal involvement in solid cancers: epidemiological, clinical and histological characteristics study of 154 onconephrology patients

Abstract Background and Aims Onconephrology is a growing discipline that aims to improve the management of patients with cancer and kidney disease. If renal histology is an essential key, the anatomopathological data remain weak. We propose an analysis of real-life data from patients managed in onconephrology consultations and had renal biopsy. Method Patients with active cancer who had a renal biopsy (RB) between 2015 and 2020 were included, and their clinicobiological and histological data were retrospectively analyzed. Our cohort consisted of 154 patients (83 women) with a mean age of 58 years who went for onconephrology care. Results One hundred twelve patients presented with proteinuria, 95 with acute renal failure, and 59 with arterial hypertension. Histologically, interstitial fibrosis was found in 74% of RBs, tubular atrophy in 55.1%, arteriolar hyalinosis in 58.4%, and fibrous endarteritis in 54.4%. Regarding the main acute lesions, thrombotic microangiopathy (TMA) was found in 29.9% of biopsies, acute tubular necrosis (ATN) in 51.3%, and acute interstitial nephritis in 24.8%. The etiological diagnosis most often made was the nephrotoxicity of anticancer drugs (87 patients), followed by a functional cause (15 patients) and renal disease unrelated to cancer (13 patients). Sixty-seven patients presented with at least 2 associated diagnoses. Different clusters were found, highlighting that anti-PD1 and anti-VEGF therapy were the most commonly involved drugs. Conclusion The nephrotoxicity of anticancer drugs was the etiology most often determined following RB this a onconephrology population, predominantly with diagnoses of TMA and ATN. Chronic histological lesions were very common. The etiological diagnoses were sometimes mixed, and primary or paraneoplastic glomerulopathies were detected mainly through histology.