{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T09:35:14Z","timestamp":1777628114813,"version":"3.51.4"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Ther Apher Dial"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Kidney Replacement Therapy (KRT) timing in septic shock remains debated. We assessed temporal trends in KRT initiation and outcomes in Japan.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using a nationwide EMR database (2016\u20132023), we included adults (\u2265\u200920\u2009years) with septic shock admitted to the intensive care unit (ICU) or high\u2010dependency care unit (HDU) on day 0 who received KRT. Outcomes were KRT timing by hospital day, in\u2010hospital mortality, and KRT dependency at discharge; sensitivity analyses used consistently reporting hospitals.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 688 hospitalizations (median age 74\u2009years), KRT initiation shifted later, with day \u2265\u20092 initiation reaching 38.5% in 2023. In 2022, mortality was 54.3% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200925), and KRT dependency was 43.5% (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200920). Patterns were similar across modalities\/settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>KRT initiation shifted toward later timing after 2022. Studies with granular severity and indication data are needed to clarify drivers of variation and outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/1744-9987.70134","type":"journal-article","created":{"date-parts":[[2026,3,20]],"date-time":"2026-03-20T00:29:15Z","timestamp":1773966555000},"page":"403-411","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Timing of Kidney Replacement Therapy Initiation in\u00a0Patients With Septic Shock: A Descriptive Study Using\u00a0a Japanese Inpatient Database"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2930-1881","authenticated-orcid":false,"given":"Ken\u2010ichi","family":"Kano","sequence":"first","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6084-9845","authenticated-orcid":false,"given":"Kayoko","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6483-3026","authenticated-orcid":false,"given":"Hiroki","family":"Shimada","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0903-0201","authenticated-orcid":false,"given":"Chikashi","family":"Takeda","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto Japan"},{"name":"Department of Anesthesia Kyoto University Hospital  Kyoto Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7477-4071","authenticated-orcid":false,"given":"Koji","family":"Kawakami","sequence":"additional","affiliation":[{"name":"Department of Pharmacoepidemiology Graduate School of Medicine and Public Health, Kyoto University  Kyoto 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