Pediatric oncology and hematopoietic cell transplant (HCT) patients are susceptible to both acute kidney injury (AKI) and chronic kidney disease (CKD). The etiologies of AKI vary but include tumor infiltration, radiation, drug-induced toxicity, and fluid and electrolyte abnormalities including tumor lysis syndrome. HCT patients can also have additional complications such as sinusoidal obstructive syndrome, graft-versus-host disease, or thrombotic microangiopathy. For patients with severe AKI requiring dialysis, multiple modalities can be used successfully, although continuous kidney replacement therapy (CKRT) is often the principal modality for critically ill patients. While increasing numbers of pediatric cancer and HCT patients are now surviving long term, they remain at risk for a number of chronic medical conditions, including CKD. Certain high-risk patients, due to underlying risk factors or treatment-related complications, eventually develop kidney failure and may require kidney replacement therapies. Management of co-morbidities and complications associated with kidney failure, including use of erythropoietin for anemia and potential need for ongoing cancer-related treatment while on dialysis, is an additional consideration in this patient population. Kidney transplantation can be successfully performed in pediatric cancer survivors, although additional features such as specific cancer diagnosis and duration of remission should be considered.

小儿肿瘤学和造血细胞移植 (HCT) 患者易患急性肾损伤 (AKI) 和慢性肾病 (CKD)。AKI 的病因多种多样，但包括肿瘤浸润、辐射、药物诱导的毒性以及包括肿瘤溶解综合征在内的液体和电解质异常。HCT 患者还可能有其他并发症，例如窦性阻塞综合征、移植物抗宿主病或血栓性微血管病。对于需要透析的严重 AKI 患者，可以成功使用多种方式，尽管连续肾脏替代治疗 (CKRT) 通常是重症患者的主要方式。虽然越来越多的儿科癌症和 HCT 患者现在可以长期存活，但他们仍然面临许多慢性疾病的风险，包括 CKD。由于潜在的风险因素或治疗相关并发症，某些高危患者最终会发展为肾功能衰竭，并可能需要肾脏替代疗法。与肾功能衰竭相关的合并症和并发症的管理，包括使用促红细胞生成素治疗贫血以及在透析期间可能需要持续的癌症相关治疗，是该患者群体的另一个考虑因素。肾移植可以在儿童癌症幸存者中成功进行，但应考虑特定癌症诊断和缓解持续时间等其他特征。与肾功能衰竭相关的合并症和并发症的管理，包括使用促红细胞生成素治疗贫血以及在透析期间可能需要持续的癌症相关治疗，是该患者群体的另一个考虑因素。肾移植可以在儿童癌症幸存者中成功进行，但应考虑特定癌症诊断和缓解持续时间等其他特征。与肾功能衰竭相关的合并症和并发症的管理，包括使用促红细胞生成素治疗贫血以及在透析期间可能需要持续的癌症相关治疗，是该患者群体的另一个考虑因素。肾移植可以在儿童癌症幸存者中成功进行，但应考虑特定癌症诊断和缓解持续时间等其他特征。