Kidney Week

Abstract: TH-PO0740

Kidney Function Trajectories and Risk of ESKD After CKRT in Sepsis-Associated AKI

Session Information

• AKI: Critical Care, CKRT, Cardiorenal Syndromes, and Clinical Outcomes
  October 22, 2026 | Location: Exhibit Hall A, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 102 AKI: Clinical, Outcomes, and Trials

Authors

• Jeong, Seung Hee, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

Seung Hee Jeong, MD

• Lee, Ha-Eun, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

Ha-Eun Lee, MD

• Oh, Ju hwan, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

Ju hwan Oh, MD

• Cho, A young, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

A young Cho, MD

• Sun, In O, Presbyterian Medical Center, Jeonju-si, Jeollabuk-do , Korea (the Republic of)

In O Sun, MD, PhD

Background

Sepsis-associated acute kidney injury (SA-AKI) requiring continuous kidney replacement therapy (CKRT) is associated with high mortality and lasting kidney damage. This study investigated the risk of end-stage kidney disease (ESKD) based on kidney function trajectories in survivors of SA-AKI requiring CKRT.

Methods

From 2011 to 2024, 820 adult patients received CKRT for SA-AKI. After excluding those with preexisting ESKD on dialysis, in-hospital deaths, and missing serum creatinine (SCr) data, 126 patients were included (Fig. 1).
Acute kidney disease (AKD) was defined at 7 days after CKRT initiation as a ≥50% increase in SCr or the ongoing need for kidney replacement therapy. Progression was defined as meeting AKD criteria at 90 days. Patients were classified into three groups: early recovery, progression, and late recovery after AKD. The primary outcome was the development of ESKD.

Results

Among 126 survivors, 53, 36, and 37 patients were classified into the early recovery, progression, and late recovery after AKD groups, respectively (Fig. 1). ESKD occurred in 2 of 53 patients (3.8%), 21 of 36 (58.3%), and 3 of 37 (8.1%) in the respective groups, with a significant difference among groups (P<0.001; Fig. 2). In multivariable Cox analysis, the progression group was significantly associated with a higher ESKD risk than the early recovery group (adjusted HR 21.22; 95% CI 4.48-100.52; P<0.001), whereas the late recovery after AKD group was not.

Conclusion

Distinct kidney function trajectories after CKRT for SA-AKI underscore the importance of 90-day kidney function monitoring to identify patients at high risk for ESKD.

Figure 1. Study population and kidney function trajectory groups

Figure 2. Cumulative incidence fo ESKD