{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T12:27:44Z","timestamp":1793968064157,"version":"4.8.0"},"reference-count":26,"publisher":"SAGE Publications","issue":"10","license":[{"start":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T00:00:00Z","timestamp":1783036800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Int J Artif Organs"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To evaluate whether adding therapeutic plasma exchange (PE) to continuous renal replacement therapy plus hemoperfusion (CRRT\u2009+\u2009HP) could improve renal recovery with wasp sting\u2013associated acute kidney injury (AKI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We conducted a multicenter retrospective cohort study in three tertiary hospitals in the Qinling region of China (July 2015\u2013December 2024). Patients received either CRRT\u2009+\u2009HP or CRRT\u2009+\u2009HP\u2009+\u2009PE within a 72-h exposure window. The primary endpoint was renal recovery, which was analyzed in a competing-risk framework with death as the competing event. Cumulative incidence of renal recovery were compared using Gray\u2019s test, and fine\u2013Gray models estimated subdistribution hazard ratios (sHR). Longitudinal changes in key laboratory variables and SOFA scores were assessed with linear mixed-effects models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Among 176 eligible patients (CRRT\u2009+\u2009HP,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u2009103; CRRT\u2009+\u2009HP\u2009+\u2009PE,\n                      <jats:italic toggle=\"yes\">n<\/jats:italic>\n                      \u2009=\u200973), baseline severity was higher in the PE group before matching but was well balanced after propensity score matching. In the matched cohort, the CRRT\u2009+\u2009HP+PE group had a higher 30\u2009days cumulative incidence of renal recovery than CRRT\u2009+\u2009HP (54.2% vs 32.2%). Overall renal recovery CIF curves favored CRRT\u2009+\u2009HP+PE (Gray\u2019s test, \u03c7\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20096.277,\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.0122). In univariable fine\u2013Gray analysis, PE was associated with increased renal recovery (sHR\u2009=\u20091.56, 95% CI 1.07\u20132.27;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009=\u20090.021), and the association remained significant after multivariable adjustment (sHR 3.97, 95% CI 1.59\u201310.08;\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      \u2009&lt;\u20090.001). 90-day mortality was numerically lower with PE but not statistically significant. Serum creatinine, total bilirubin, and SOFA score trajectories were improved faster in the CRRT\u2009+\u2009HP\u2009+\u2009PE group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>For patients with AKI caused by wasp stings, the addition of PE to CRRT\u2009+\u2009HP can improve early renal recovery and yield more favorable laboratory trajectories.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/03913988261456903","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:51:36Z","timestamp":1783075896000},"page":"679-688","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Therapeutic plasma exchange added to CRRT combined with hemoperfusion in wasp sting-associated AKI: A multicenter retrospective cohort study"],"prefix":"10.1177","volume":"49","author":[{"given":"Rong","family":"Li","sequence":"first","affiliation":[{"name":"Department of Nephrology, Shaanxi Provincial People\u2019s Hospital, Xi\u2019an, Shaanxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nan","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Ankang Central Hospital, Ankang, Shaanxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dongju","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hanzhong Central Hospital, Hanzhong, Shaanxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chunyan","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Shaanxi Provincial People\u2019s Hospital, Xi\u2019an, Shaanxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhishuang","family":"Zhai","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Xunyang People\u2019s Hospital, Xunyang, Shaanxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoli","family":"Cheng","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Ankang Central Hospital, Ankang, Shaanxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Hanzhong Central Hospital, Hanzhong, Shaanxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9381-8511","authenticated-orcid":false,"given":"Peng","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Nephrology, Shaanxi Provincial People\u2019s Hospital, Xi\u2019an, Shaanxi Province, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,3]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2024.108112"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0083164"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2021.11.005"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.4103\/0972-5229.142181"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2015.12.013"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00204-020-02859-3"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-023-07211-8"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.ajkd.2024.09.015"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1177\/0391398819881459"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00134-022-06810-1"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1159\/000514284"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.2215\/CJN.12081112"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1159\/000442740"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.4103\/0970-258X.308235"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12882-025-04403-w"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfab201"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1159\/000339789"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcrc.2025.155076"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2020.05.002"},{"key":"e_1_3_3_21_2","article-title":"KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease","volume":"105","author":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group","year":"2024","unstructured":"Kidney Disease: Improving Global Outcomes (KDIGO) CKD Work Group. KDIGO 2024 clinical practice guideline for the evaluation and management of chronic kidney disease. Kidney Int 2024; 105(4S): S117\u2013S314.","journal-title":"Kidney Int"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.18457"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1093\/ckj\/sfw004"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.toxicon.2019.03.008"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1080\/0886022X.2023.2259230"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.kint.2017.05.035"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/qjmed\/hcaa132"}],"container-title":["The International Journal of Artificial Organs"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03913988261456903","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/03913988261456903","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/03913988261456903","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T11:52:45Z","timestamp":1793965965000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/03913988261456903"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,3]]},"references-count":26,"journal-issue":{"issue":"10","published-print":{"date-parts":[[2026,10]]}},"alternative-id":["10.1177\/03913988261456903"],"URL":"https:\/\/doi.org\/10.1177\/03913988261456903","relation":{},"ISSN":["0391-3988","1724-6040"],"issn-type":[{"value":"0391-3988","type":"print"},{"value":"1724-6040","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,3]]}}}