{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T11:43:17Z","timestamp":1771328597231,"version":"3.50.1"},"reference-count":32,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T00:00:00Z","timestamp":1771286400000},"content-version":"vor","delay-in-days":47,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"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":["Critical Care Research and Practice"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Persistent severe acute kidney injury (PS\u2010AKI)\u2014recently standardized as Kidney Disease: Improving Global Outcomes (KDIGO) Stage 3 persisting \u2265\u200972\u2009h, or renal replacement therapy\/death after Stage 3 diagnosis\u2014has emerged as a trajectory\u2010based phenotype complementing conventional KDIGO staging. Evidence in contemporary intensive care unit (ICU) cohorts remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively studied adults admitted to a tertiary ICU (January 2024\u2013June 2025). Acute kidney injury (AKI) was staged per KDIGO 2012, with trajectories classified as Stage 1 AKI, transient AKI (Stage 2\u20103 resolving within 48\u2009h), persistent mild\u2013moderate AKI, or PS\u2010AKI. The primary outcome was in\u2010hospital mortality; secondary outcomes included renal recovery. Predictors of PS\u2010AKI were explored using logistic regression and gradient boosting with SHAP attribution.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 139 ICU patients with AKI screened, 106 met criteria. Most AKI was community\u2010acquired (97\/106, 91.5%). PS\u2010AKI accounted for 23% (24\/106) and carried the worst outcomes, with in\u2010hospital mortality 54% and renal recovery 17%. Within Stage 2\u20103, PS\u2010AKI was associated with substantially worse outcomes than non\u2010PS trajectories (mortality 54% vs 10.8%; adjusted HR for death 2.23, 95% CI 0.69\u20137.21; adjusted OR for renal recovery 0.07, 95% CI 0.01\u20130.24). A 72\u2010h landmark analysis showed similar but nonsignificant trends. Inflammatory profiles distinguished PS\u2010AKI, with higher neutrophil\u2010to\u2010lymphocyte ratio (NLR), C\u2010reactive protein (CRP), and lower platelets. The composite NLR\u2010to\u2010platelet ratio (NLR\/PLT) was independently associated with PS\u2010AKI (adjusted OR 2.51 per doubling, 95% CI 1.52\u20134.12; AUC 0.86), while the systemic immune\u2010inflammation index (SII) showed no significant association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In this predominant community\u2010acquired ICU cohort, PS\u2010AKI was common and strongly associated with poor in\u2010hospital outcomes. The co\u2010occurrence of inflammation and thrombocytopenia, summarized by NLR\/PLT, may represent a simple exploratory signal for early\u2010risk appraisal. These findings support further research into trajectory\u2010based AKI phenotypes and the potential utility of inflammation\u2013hematologic markers in predicting persistence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/ccrp\/6920702","type":"journal-article","created":{"date-parts":[[2026,2,17]],"date-time":"2026-02-17T10:56:13Z","timestamp":1771325773000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Persistent Severe Acute Kidney Injury Among Critically Ill Patients: Outcomes and Predictive Markers\u2014A Single\u2010Center Retrospective Cohort Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3795-2577","authenticated-orcid":false,"given":"Tung Phi","family":"Nguyen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-9289-3242","authenticated-orcid":false,"given":"Thang 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