{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T23:55:20Z","timestamp":1790898920753,"version":"4.1.0"},"reference-count":24,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int Urol Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>Obstructive acute kidney injury (AKI) is a significant clinical entity with varying outcomes. This study aims to describe the clinical, diagnostic, and therapeutic characteristics of obstructive AKI in a large cohort of adult patients and to identify predictors of in-hospital mortality and the need for renal replacement therapy (RRT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective, observational single-center study at the Fondazione Policlinico Universitario A. Gemelli IRCCS (Rome, Italy). Adult patients presenting to the Emergency Department between 2018 and 2022 with KDIGO-defined AKI and a documented diagnosis of urinary tract obstruction established during the index Emergency Department evaluation were included. Multivariable logistic regression analysis was performed to identify independent predictors of in-hospital mortality and RRT requirement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 1,351 patients (median age 71 years). In-hospital mortality was 12% (n=167), and RRT was required in 6% (n=80). Independent predictors of mortality included older age, higher triage priority\u00a0(OR 4.96, 95% CI 2.99\u20138.20), higher serum creatinine, and lower hemoglobin. A significant interaction was found between pre-existing chronic kidney disease (CKD) and RRT\u00a0(OR 11.11, 95% CI 1.23\u2013100.02), identifying a subgroup with the highest mortality risk. Predictors for RRT included admission serum creatinine\u00a0(OR 1.37, 95% CI 1.16\u20131.62)\u00a0and pre-existing CKD\u00a0(OR 5.26, 95% CI 1.22\u201322.73).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Obstructive AKI is associated with substantial mortality, particularly in elderly patients and those with pre-existing CKD \u00a0who required RRT during hospitalization. The interaction between CKD and RRT highlights a vulnerable population where serum creatinine alone may underestimate clinical risk. Early risk stratification using functional and laboratory markers is essential to guide management.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11255-026-05361-4","type":"journal-article","created":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T10:23:47Z","timestamp":1790850227000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Obstructive acute kidney injury: predictors of mortality and need for renal replacement therapy"],"prefix":"10.1007","author":[{"given":"Lucrezia","family":"Dimartino","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicola","family":"Panocchia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlo Pasquale","family":"Piccinni","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcello","family":"Covino","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Franceschi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Cecere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1213-2177","authenticated-orcid":false,"given":"Giuseppe","family":"Grandaliano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesco","family":"Pesce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"5361_CR1","doi-asserted-by":"publisher","first-page":"c179","DOI":"10.1159\/000339789","volume":"120","author":"A Khwaja","year":"2012","unstructured":"Khwaja A (2012) KDIGO clinical practice guidelines for acute kidney injury. 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