肿瘤相关性急性肾损伤(AKI)是肿瘤患者常见的严重并发症，影响患者的生存率。肿瘤相关性AKI主要见于多发性骨髓瘤、淋巴瘤、白血病、肾癌及造血干细胞移植治疗，化疗及生物靶向治疗也是重要病因。危险因素包括年龄>65岁、原有慢性肾脏病(CKD)、合并其他疾病、低血容量、败血症、造影剂肾病，使用肾毒性药物、巨大肿瘤负荷或广泛转移、广泛手术、低心排出量及尿路梗阻等。除肿瘤引起的肾前性因素、肾小管间质损伤及尿路梗阻外，溶瘤综合征及肿瘤治疗也参与AKI的发病。以预防为主、干预上述危险因素，选用合理化疗药物及剂量，及时诊断与正确处理AKI尤为重要。新的措施，如高截留量的血液透析(HCO-HD)可改善多发性骨髓瘤肿瘤相关AKI的预后。

Tumor-associated acute kidney injury (AKI) is a common serious complication of cancer patients, affecting the survival rate of patients and leading to increased mortality. Tumor-associated AKI is mainly found in multiple myeloma, lymphoma, leukemia, renal cancer, and hematopoietic stem cell transplantation, with chemotherapy and biotargeted therapy also being important causes. The risk factors include age over 65 years, previous chronic kidney disease, complicated diseases, hypovolemia, sepsis, contrast nephropathy, use of nephrotoxic drugs, large tumor burden or extensive metastases, extensive surgery, low cardiac output, and urinary tract obstruction, and so on. In addition to tumor-induced pre-renal factors, tubulointerstitial damage, and urinary tract obstruction, tumor lysis syndrome (TLS) and anti-cancer therapy are also involved in the pathogenesis of AKI. Taking prevention as the main method, interfering with the above risk factors, selecting rational chemotherapy drugs and dosages, and timely diagnosis and correct treatment of AKI are particularly important. New measures such as high-cutoff hemodialysis (HCO-HD) can improve the prognosis of tumor-associated AKI in multiple myeloma.