Department of Intensive Care Medicine, Medical Unit, 12K12IB, Ghent University Hospital, De Pintelaan 185, 9000 Gent, Belgium.
Crit Care Clin. 2010 Jan;26(1):151-79. doi: 10.1016/j.ccc.2009.09.002.
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.
危重症癌症患者接受肾脏替代治疗的急性肾损伤发生率高于非癌症危重症患者。急性肾损伤可能是癌症本身、其治疗或相关并发症的直接或间接后果。最近的几项研究表明，仅存在潜在癌症本身已不再被认为是开始肾脏替代治疗或其他危重症患者生命支持措施的禁忌症。然而，这些相对较好的结果不应该被用来证明不合理的治疗坚持，也不应该拒绝处于绝望境地的癌症患者的姑息治疗。与任何其他危重症患者一样，开始生命支持治疗的决定及其持续时间应与患者的长期预期预后和生活质量成正比。
