Cardiovascular and Renal Risk Stratification in Patients Referred to an Onconephrology Clinic and Undergoing Different Oncology Therapies: A Real-World Study

Background: Onconephrology is an emerging field addressing renal and cardiovascular complications in patients with cancer. Kidney disease and cardiovascular risk frequently coexist and may significantly affect oncological outcomes. Methods: We conducted a single-center, prospective, observational study including adult oncological patients. Patients were evaluated at baseline and after 1, 3, and 12 months. Renal outcomes (Acute Kidney Injury (AKI), Chronic Kidney Disease (CKD), AKI on CKD, Acute Kidney Disease (AKD)), cardiovascular risk assessment scores (using the SCORE/SCORE2 systems), and major adverse kidney events (MAKEs) were recorded. Results: Eighty-three patients were enrolled (mean age 69.8 ± 11.6 years, 60.2% male). At baseline, AKI was present in 30.4%, CKD in 27.8%, and AKI on CKD in 16.5% of patients. Overall, 96.7% of the cohort was classified as having a high or very high cardiovascular risk. During follow-up, 18.1% experienced new AKI, and MAKEs occurred in 30.4% of patients, driven primarily by mortality. Male sex emerged as the main predictor of death. Conclusions: Onconephrology patients suffer from a high burden of renal disease and cardiovascular risk. Integrated nephrological and cardiovascular assessment may represent a key component of personalized cancer care.