Abstract: SA-PO0227
Developing an Onconephrology Clinic in a Safety Net Hospital
Session Information
- Onconephrology: MGRS, HSCT, Electrolytes, RCC, and More
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Onconephrology
- 1700 Onconephrology
Authors
- Kala, Jaya, The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, United States
- Teakell, Jade M., The University of Texas Health Science Center at Houston John P and Katherine G McGovern Medical School, Houston, Texas, United States
- Patel, Tejal, MD Anderson Oncology Program at LBJ Hospital, Houston, Texas, United States
- Ma, Hilary Y, MD Anderson Oncology Program at LBJ Hospital, Houston, Texas, United States
Background
Onconephrology(ON) is a growing subspeciality focusing on patients(pts) with cancer who develop kidney disorders ranging from proteinuria, hypertension, acute kidney injury(AKI), chronic kidney disease(CKD), and/or electrolyte abnormalities. Dedicated ON clinics have emerged across US affiliated often with major cancer centers. Safety net hospital, such as Harris Health System(HHS) provides medical services to individuals who are uninsured, low-income, have limited access to healthcare due to financial/other circumstances. These include racial/ethnic minorities of low socioeconomic status, low health literacy and/or limited English proficiency. This medically vulnerable population(MVP) is at higher risk of experiencing disparities in medical care leading to inadequate access, quality and timely care. Studies have shown that MVP in US have disproportionately large burden of CKD with higher rates of CKD-associated morbidity and mortality. AKI is common in cancer(incidence~17.5%),in critically ill(incidence 54%),and nearly 5.1% require long term dialysis within a year. Here we report the successful implementation of ON clinic in HHS in 2022.
Methods
We extracted data from ON clinic(1/2day clinic/week) on in-person office visits(OV) and E(electronic)consults from January2022-April2025. We manually collected data on demographics, reasons for consultation, laboratory results, and kidney biopsies.
Results
Average pt age was 62years; female46%, 59%Hispanic/Latinx, 28%Black, 9%White;52% were uninsured. Total number of encounters were 267(187OV;4 telemedicine, 76Econsults). Of the Econsults, only 35% needed OV evaluation while the rest were successfully managed with recommendations to oncologists, avoiding loss of wages for pts, parking expenses, and time in clinic. Among the Econsults, 46% were converted to OV within 1month, 46% between 1-6months, and 8% in >6months. This was shorter than the usual wait time in general nephrology clinic which is ~ >6 months. 14pts had proteinuria (8drug-induced,11 biopsied), 41%AKI, 11%CKD, 13%electrolyte abnormalities, 6%hypertension, and 5% on dialysis.
Conclusion
Our data indicates feasibility of implementing subspeciality clinics in safety-net healthcare systems. Dedicated staff and utilization of services such as Econsults, are key to timely and successful implementation of kidney care in MVP with cancer.