Acute kidney injury in critically ill patients with cancer.

Critically ill cancer patients have a higher incidence of acute kidney injury treated with renal replacement therapy than critically ill patients without cancer. Acute kidney injury may occur as a direct or indirect consequence of the cancer itself, its treatment, or associated complications. Several recent studies have shown that the presence of an underlying cancer alone can no longer be considered a contraindication to initiate renal replacement therapy or other advanced life-supportive measures in critically ill patients. However, these relatively good results should not be used to justify unrealistic therapeutic perseverance or to withhold palliative care in cancer patients who are in a desperate situation. Similar to that for any other critically ill patient, the decision to initiate advanced life-supportive therapy as well as its duration should be in proportion with the patient's expected long-term prognosis and quality of life.