Kidney Week

Abstract: TH-PO0732

Adsorptive vs. Standard CKRT in Septic Shock-Associated AKI: A Propensity Score-Matched Cohort Study

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

• Kim, Jeeyoung, Chung Ang University Hospital, Dongjak-gu, Seoul, Korea (the Republic of)

Jeeyoung Kim, MD

• Yun, Donghwan, Seoul National University College of Medicine, Jongno-gu, Seoul, Korea (the Republic of)

Donghwan Yun, MD

• Kim, Minsang, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)

Minsang Kim, MD

• Park, Sehoon, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)

Sehoon Park, MD, PhD

• Kim, Yong Chul, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)

Yong Chul Kim, MD, PhD

• Kim, Dong Ki, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)

Dong Ki Kim, MD, PhD

• Oh, Kook-Hwan, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)

Kook-Hwan Oh, MD, PhD

• Joo, Kwon Wook, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)

Kwon Wook Joo, MD, PhD

• Kim, Yon Su, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)

Yon Su Kim, MD, PhD

• Han, Seung Seok, Seoul National University Hospital Department of Internal Medicine, Jongno-gu, Seoul, Korea (the Republic of)

Seung Seok Han, MD, PhD

Background

Septic shock with concurrent acute kidney injury (AKI) carries high mortality in the ICU. Adsorptive membranes enhance conventional continuous kidney replacement therapy (CKRT) beyond diffusion and convection, but whether this improves survival remains unclear.

Methods

We conducted a prospective study with retrospective controls at Seoul National University Hospital ICUs (December 2023–2025). Patients requiring CKRT with vasopressor support and antibiotics received the Oxiris membrane for 48 hours with 24-hour filter exchanges, then transitioned to a standard membrane. Controls received standard polysulfone membranes. After 1:1 propensity score matching on age, sex, APACHE II score, mechanical ventilation, and eGFR, survival was analyzed using Kaplan–Meier curves and multivariable Cox regression.

Results

After PSM, 49 matched pairs showed well-balanced baseline characteristics including similar age (median 69 years), APACHE II scores (median 34 vs. 32), and universal mechanical ventilation use (100%). Kaplan–Meier analysis showed a tendency of higher survival in the Oxiris group across all time points (28-day: 51.0% vs. 38.8%; 60-day: 46.9% vs. 34.7%; 90-day: 44.8% vs. 32.7%; 240-day: 42.7% vs. 30.1%; log-rank p=0.3). Multivariable Cox regression confirmed a consistent trend toward lower mortality with Oxiris across all model specifications (unadjusted HR 0.775, 95% CI 0.473–1.27; adjusted HR 0.734, 95% CI 0.432–1.245).

Conclusion

In this real-world ICU cohort, adsorptive CKRT was associated with higher survival at all observed time points compared to standard CKRT. Although statistical significance was not reached, likely reflecting the limited sample size, the consistent survival signal supports a potential mortality benefit. Larger multicenter prospective studies are warranted to confirm these findings.

Kaplan–Meier survival curves comparing Oxiris (OXI) and standard polysulfone (FMC) membranes after propensity score matching.

Funding

• Commercial Support – Vantive Health LLC