Abstract
Subspecialized training in the field of onconephrology offers a uniquely informed approach to the care of the patient with both cancer and kidney disease. There is a significant knowledge gap that has been created by the fact that patients with an estimated glomerular filtration rate <30 mL/min are generally excluded from clinical cancer trials. Thus, oncologists rely on the clinical experience and expertise of onconephrologists to dose cytotoxic chemotherapies, to recognize and manage complications of newer targeted drugs and immunotherapies, to become partners in establishing guidelines relating to the management of these complications, and to collaborate on the design of future clinical trials in this cohort. In this section, we provide a glimpse into some common clinical scenarios encountered by the onconephrologist and demonstrate how clinical data and observations inform decision-making in these situations.