{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T06:49:56Z","timestamp":1791614996683,"version":"4.3.4"},"reference-count":30,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"vor","delay-in-days":27,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dialysis-requiring acute kidney injury (AKI-D) is a frequent and severe in-hospital complication associated with high mortality, long-term kidney sequelae, and substantial resource use. National data on AKI-D impact and service organization in Italy are limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a nationwide, web-based, 20-item survey endorsed by the Italian Society of Nephrology. We assessed care settings (dialysis units and other wards, including intensive care units [ICUs]), kidney replacement therapy (KRT) modalities in ICUs, staffing models, monitoring and anticoagulation strategies, and nephrologists' perspectives on barriers and priorities for improvement.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Fifty-nine centers responded; analyses focused on 57 adult centers. AKI-D represented \u223c20% to &amp;gt;60% of dialysis-unit activity. KRT was frequently delivered outside nephrology wards, most often in cardiac intensive care units (94%) and emergency departments (50.8%). In ICUs, nephrologists primarily prescribed KRT in 73.7% of centers; continuous KRT (CKRT) was available in 94.7%, and regional citrate anticoagulation was first-line in 82.5%. Dialysis dose was reassessed daily in 55.2% of centers. Routine antibiotic therapeutic drug monitoring during CKRT was available in 30.3%, and in 22.8% dedicated post-AKI outpatient clinics. Most indicators were similar between center types; however, structured antibiotic therapeutic drug monitoring during CKRT was more frequently available in University and Hub centers than in Spokes (43.5 vs 31.6 vs 7.1%, respectively, P = .031). Respondents highlighted heterogeneous protocols, limited dedicated staffing, and gaps in multidisciplinary coordination.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>AKI-D care in Italy is widespread but organizationally heterogeneous across settings, responsibilities, and key operational practices. Standardized pathways, training, and measurable monitoring tools are key priorities for improvement.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/joneph\/aajag088","type":"journal-article","created":{"date-parts":[[2026,4,8]],"date-time":"2026-04-08T11:58:47Z","timestamp":1775649527000},"page":"1196-1205","source":"Crossref","is-referenced-by-count":0,"title":["Real-world management of dialysis-requiring acute kidney injury in Italy: a national survey of nephrology centers"],"prefix":"10.1093","volume":"39","author":[{"given":"Erika","family":"Naso","sequence":"first","affiliation":[{"name":"Nephrology and Dialysis Unit, ASLCN1 , Cuneo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8277-1607","authenticated-orcid":false,"given":"Paolo","family":"Fabbrini","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, ASST Nord , Milano ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marita","family":"Marengo","sequence":"additional","affiliation":[{"name":"Nephrology and Dialysis Unit, ASLCN1 , Cuneo ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Fiorentino","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Unit, Department of Precision and Regenerative Medicine and Ionian Area, University of Bari Aldo Moro , Bari ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Castellano","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Ca\u2019 Granda Ospedale Maggiore Policlinico , Milan ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincenzo","family":"Cantaluppi","sequence":"additional","affiliation":[{"name":"Nephrology and Kidney Transplantation Unit, Department of Translational Medicine (DIMET), University of Piemonte Orientale (UPO), AOU Maggiore Della Carit\u00e0 , Novara ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0834-5586","authenticated-orcid":false,"given":"Pasquale","family":"Esposito","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine and Medical Specialties (DIMI), University of Genova , Genova ,","place":["Italy"]},{"name":"Unit of Nephrology, Dialysis and Transplantation, IRCCS Azienda Ospedaliera Metropolitana, Policlinico San Martino , Genova ,","place":["Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"2026101002222625100_aajag088-B1","doi-asserted-by":"publisher","first-page":"170","DOI":"10.1016\/S0140-6736(13)60647-9","article-title":"Acute kidney injury: an increasing global 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