Symptom control measures should be modified in cancer patients who have concurrent renal failure as well as those with non malignant causes of end stage renal failure.
Cancer patients may develop renal impairment due to:
- ureteric obstruction caused by compression by a pelvic tumour, or
- as a consequence of a concurrent illness
If clinically appropriate the origin of the renal impairment should be investigated and corrected if possible
e.g. stenting in ureteric obstruction
causes of pain and other symptoms should be identified and treated appropriately.
Disease specific causes of pain include:
- Underlying disease e.g. polycystic kidney disease, diabetic neuropathy
- Renal disease and its treatment e.g. calciphylaxis (tissue ischaemia due to calcification of tissue and small arteries in dialysis patients); ischaemic neuropathies due to A-V fistulae; peritonitis due to peritoneal dialysis
Stage of renal disease will guide management.
|1||>90 mL/min||Normal renal function|
|2||60–89 mL/min||Mildly reduced renal function|
|3||30–59 mL/min||Moderately reduced renal function|
|4||15–29 mL/min||Severely reduced renal function|
|5||<15 mL/min||Very severe or ESRD|
eGFR estimated glomerular filtration rate