NephMadness 2015: Onconephrology • First Round Results
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Nephron-Sparing Surgery versus Nephrectomy for Renal Cancer
Winner: Nephron-Sparing Surgery
Taking the kidney out and curing the cancer is a truly life saving surgery. But curing the cancer and saving nephrons is even more amazing! The nephrologists have to move ahead in this round over the urologists. More GFR is always better and more nephron mass is truly the best option. Nephron sparing surgery truly has revolutionized the care of the renal cell cancer patient. Nephron sparing surgery clearly has totaled nephrectomy for renal cell cancer.
Tyrosine Kinase Inhibitor toxicity barely versus VEGF-Inhibitors Toxicity
Winner: Tyrosine Kinase Inhibitor toxicity
Tyrosine Kinase toxicity barely escapes over VEGF-Inhibitors toxicity. Targeted therapies are the future of cancer and chemotherapy. While VEGF-inhibitors taught us a lot about the podocyte biology; their toxicities only was limited to the podocyte and the endothelium. The tyrosine kinase inhibitors have casted a wider net involving not only the glomeruli, but tubules, interstitial and electrolytes. Given the wide degree of damage, there is a lot to learn from these agents. They clearly have an upper hand over the anti-VEGF agents.
Transplant after Malignancy versus Post-Transplant Malignancy
Winner: Post-Transplant Malignancy
Post-transplant malignancy had a tight win over transplant after malignancy. With transplant patients living longer and longer, the potential for malignancy to occur rises. In addition the immunosuppression used to prolong graft survival can increase susceptibility to malignancy. The decision to allow a transplant to proceed after malignancy is a hard decision but with novel agents available to treat cancer and cure cancer, this component of transplant is going to change.
Amyloidosis versus Myeloma Kidney
Winner: Myeloma Kidney
This was a tight battle with a 4-3 split in favor of myeloma kidney. Cast nephropathy is the most common form of renal injury in myeloma giving the team a deep bench to go to down the stretch. Amyloidosis still remains an enigma to us. A tough decision here but Team Myeloma Kidney advances to the next round and push Team Amyloidosis aside. Take a look at Jeffrey Zonder’s post about novel therapies on the rise for amyloidosis.
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