Renal Dysfunction Complicating the Management of Hematologic Diseases

Renal dysfunction is common in patients with hematologic diseases and frequently emerges at diagnosis or during treatment. Acute kidney injury, chronic kidney disease, and glomerular involvement may arise from disease biology, antineoplastic therapy, infection, transplantation-related injury, or cumulative supportive exposures. In clinical practice, impaired kidney function rarely represents an isolated comorbidity; rather, it modifies therapeutic feasibility, dose intensity, supportive management, and long-term outcomes. Renal impairment affects delivery of conventional chemotherapy, targeted and immune-based therapies, complicates antimicrobial selection during immunosuppression, and influences eligibility and risk stratification for hematopoietic stem cell transplantation (HSCT). Beyond its immediate consequences, renal dysfunction carries prognostic significance and may reshape therapeutic goals as renal reserve evolves. Considering renal dysfunction as a modifier of hematologic management, rather than solely as a renal endpoint, clarifies its role in treatment planning across the disease continuum.