The Duke onconephrology clinic provides nephrology subspecialty consultation for:
The number of people living with cancer has been increasing steadily. The aging population, improved cancer diagnostic tools, and decrease in cancer-related mortality have contributed to this increase.
Onco-nephrology at Duke is a highly integrated and rapidly growing clinical program dedicated to the care of patients with cancer who develop kidney-related complications. Kidney disease is common among patients with malignancy and reflects a complex, bidirectional relationship in which cancer, its complications, and its treatments all contribute to kidney injury. Malignancies can directly affect the kidneys through tumor infiltration, obstruction, or the production of nephrotoxic proteins, while cancer-associated processes such as thrombotic microangiopathy, electrolyte disorders, and paraneoplastic glomerular diseases further increase kidney-related morbidity.
A major focus of the Duke Onco-nephrology clinic is the prevention and management of treatment-related nephrotoxicity. With the increasing use of targeted therapies, immunotherapies, and combination regimens, the spectrum of kidney complications continues to expand and includes acute kidney injury, glomerular disease, tubular dysfunction, and immune-mediated toxicity. At the same time, patients with preexisting chronic kidney disease often face limitations in cancer treatment options, requiring careful coordination to ensure both safe and effective oncologic care.
The clinic is built on close collaboration between nephrology, oncology, pharmacy, and pathology, allowing for a multidisciplinary approach to patient care. Onco-nephrologists work alongside oncology teams to optimize kidney function, guide medication dosing, mitigate nephrotoxic exposures, and manage complications in real time so that patients can continue life-prolonging cancer therapies whenever possible.
Research is a central component of the Duke Onco-nephrology program, with active efforts to better define mechanisms of kidney injury, identify biomarkers of susceptibility and recovery, and improve prevention and treatment strategies for nephrotoxicity. Patients seen in the clinic may have opportunities to participate in clinical and translational research studies, including trials focused on kidney outcomes in cancer populations, further advancing the field while enhancing patient care.
Education is also a core mission of the clinic and is tightly integrated into the nephrology fellowship program. Fellows gain direct experience in managing complex kidney complications in patients with cancer through dedicated clinical exposure, multidisciplinary conferences, and collaboration with oncology subspecialists. This environment provides a unique and highly relevant training experience that prepares fellows to care for a growing population of patients at the intersection of nephrology and oncology, while contributing to innovation in this evolving subspecialty.
The Duke Onconephrology clinic is located in the Duke Cancer Center and is staffed by
David Ortiz-Melo, MD
Duke Onconephrology Clinic Lead
Arash Ataei, MD
Duke Onconephrologist
Contact Information
New patients: Please call 919-660-6860 to schedule an appointment. Please include Onconephrology Clinic in referrals.