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JASON PROSEK: So the development of onconephrology as a subset of special nephrology is only just beginning to grow, but what the power of this clinic provides is funneling these new observations in real time that are coming at a very rapid pace with the development of new agents. It really requires funneling those experiences to a small number of physicians to build that pattern recognition and be able to make these diagnoses faster than it might be if they were spread out over the whole group.

So as tyrosine kinase inhibitors or other targeted therapies, checkpoint inhibitors, become more mainstream, there's no doubt that the incidence of acute kidney injury and hypertension as a result of these agents will increase in capacity or in size.

We began this clinic with a very modest goal of helping our neuroendocrine cancer oncologists who are the-- an advent of using tyrosine kinase inhibitors for their metastatic thyroid disease, et cetera, that cause significant hypertension. That was the initial goal of our clinic to take care of this small population. And this has only grown, again, with the advent of new therapies that are coming down the pike. Renal implications of medications that I certainly had no knowledge of when this clinic first started. And so the impact, the number of patients we're seeing is growing exponentially. So we are expanding our practice to-- ultimately, we'll have three full time onconephrologists to take care of this patient.

I think it'll be very difficult to support the mission of a cancer hospital without having devoted onconephrologists to take care of the burden of acute kidney injury and electrolyte disorders that develop.