With increasing prevalence of both kidney disease and cancer, patients who have both are common. Toxicity from treatment or direct kidney injury by the cancer itself can lead to acute kidney injury or progression of pre-existing chronic kidney disease. Management of advanced chronic kidney disease or end-stage kidney disease among those with concomitant cancer is challenging; however, better understanding of complications in this population will allow for optimization of treatments. Strategies for medication dosing, judicious use of erythropoiesis-stimulating agents in anemia, and treatment options for mineral bone disorders will be reviewed. Among those who require dialysis, special consideration should be made surrounding medication dosing, and end-of-life care should be addressed as early as possible in a patient-centered manner.
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