肿瘤肾病学是一门不断发展的学科，旨在改善癌症和肾脏疾病患者的治疗。如果肾脏组织学是关键，那么解剖病理学数据尽管对于这种复杂的管理至关重要，但仍然很薄弱。纳入了 2014 年至 2020 年期间进行肾活检 (KB) 的活动性癌症患者，并对他们的临床生物学和组织学数据进行了回顾性分析。该队列由 154 名患者（83 名女性）组成，平均年龄为 58 岁。 112 名患者出现蛋白尿，95 名患者出现急性肾损伤，59 名患者出现动脉高血压。组织学上，74%的KB出现间质纤维化，55.1%出现肾小管萎缩，58.4%出现小动脉玻璃样变，54.4%出现纤维性动脉内膜炎。在主要的急性病变中，活检发现血栓性微血管病（TMA）占29.9%，急性肾小管坏死（ATN）占51.3%，急性间质性肾炎占24.8%。最常见的病因诊断是抗癌药物的肾毒性（87 名患者），其次是肾前性病变（15 名患者）和与癌症无关的肾脏疾病（13 名患者）。 67 名患者至少有 2 项相关诊断，反映了癌症中肾脏损害的复杂性。发现了不同的簇，突出显示免疫疗法和抗 VEGF 是最常涉及的药物。在肿瘤肾病学实践中，治疗的肾毒性是最常见的病因。可能涉及多种机制，强调了肾活检的重要性及其管理的复杂性。慢性组织学病变非常常见。© 2024。作者。

Onconephrology is a growing discipline that aims to improve the management of patients with cancer and kidney disease. If kidney histology is an essential key, the anatomopathological data remain weak although essential to this complex management.Patients with active cancer who had a kidney biopsy (KB) between 2014 and 2020 were included, and their clinicobiological and histological data were analyzed retrospectively.Our cohort consisted of 154 patients (83 women) with a mean age of 58 years. One hundred twelve patients presented with proteinuria, 95 with acute kidney injury, and 59 with arterial hypertension. Histologically, interstitial fibrosis was found in 74% of KBs, tubular atrophy in 55.1%, arteriolar hyalinosis in 58.4%, and fibrous endarteritis in 54.4%. Regarding the main acute lesions, thrombotic microangiopathy (TMA) was found in 29.9% of biopsies, acute tubular necrosis (ATN) in 51.3%, and acute interstitial nephritis in 24.8%. The etiological diagnosis most often made was the nephrotoxicity of anticancer drugs (87 patients), followed by a pre-renal (15 patients) and kidney disease unrelated to cancer (13 patients). Sixty-seven patients presented with at least 2 associated diagnoses reflecting the complexity of kidney damage in cancer. Different clusters were found, highlighting that immunotherapy and anti-VEGF were the most commonly involved drugs.During onconephrology practice, kidney toxicity of treatments is the most common etiology. Several mechanisms can be involved, underscoring the importance of kidney biopsy and the complexity of its management. Chronic histological lesions were very common.© 2024. The Author(s).