Abstract: The incidence of malignant tumors among elderly patients is increasing. Influenced by multiple factors such as aging, tumor, and drug, this population exhibits a high prevalence of renal insufficiency. However, there remains a scarcity of research data and significant challenges in clinical management. This article systematically analyzes the challenges faced in administering anti-tumor therapies to elderly patients with renal insufficiency and proposes management strategies. Optimization approaches include precise assessment of renal function, selection of nephrotoxicity-sparing medications, appropriate dose adjustments, implementation of preventive measures, and emphasis on comprehensive geriatric assessment and multidisciplinary collaboration. Renal injury management should be individualized, with considerations for special populations such as renal transplant recipients and dialysis patients. Future efforts should focus on biomarker discovery and the development of low-nephrotoxicity therapeutic agents to address these complex clinical challenges.

Key words: renal insufficiency, anti-tumor treatment, elderly patients