Abstract / Summary
Background/Objectives: This exploratory study described interleukin-6 (IL-6) and vasopressor-dependency trajectories during continuous renal replacement therapy (CRRT) with oXiris, CytoSorb, or standard haemofilters in sepsis-associated acute kidney injury, and their lagged and prognostic associations. Methods: This retrospective single-centre cohort included 48 adults receiving standard CRRT (n = 22), oXiris (n = 21), or CytoSorb (n = 5; analysed descriptively), assessed at baseline and 12, 24, and 48 h; devices were clinician-selected, implying confounding by indication. The vasopressor dependency index (VDI) was vasoactive-inotropic score/mean arterial pressure. Results: Twenty-eight-day survival was 13.6%, 33.3%, and 40.0%, respectively (p = 0.240). The unadjusted 24 h VDI decline was largest with CytoSorb (p = 0.018), but this group had much higher baseline IL-6 and VDI, and the contrast was attenuated and non-significant after baseline adjustment. No lagged association was detectable between IL-6 and subsequent VDI (β = 0.04, 95% confidence interval (CI) −0.04 to 0.13) or VDI and subsequent IL-6 (β = −0.05, 95% CI −0.20 to 0.09). In a 24 h landmark analysis, favourable haemodynamic status was associated with survival (odds ratio 7.57, 95% CI 1.75–32.69) without improving optimism-corrected discrimination beyond baseline severity and age (area under the curve 0.882). Conclusions: These hypothesis-generating findings do not establish a benefit of any device; early haemodynamic response criteria warrant prospective evaluation.