{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,7]],"date-time":"2026-08-07T15:16:15Z","timestamp":1786115775463,"version":"build-2736575974"},"reference-count":33,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Cell. Infect. Microbiol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Sepsis-associated acute kidney injury (SA-AKI) is a life-threatening condition with poor prognosis. However, due to significant inter-individual variability in disease progression, clinicians lack reliable tools to stratify patients based on long-term mortality risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This study explores how the timing of SA-AKI (early vs. late onset) affects survival, based on the latest ADQI consensus, and aims to build a simple nomogram to predict 1-year mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study enrolled 422 SA-AKI patients (from 3273 sepsis patients) admitted to the First Affiliated Hospital of Zhengzhou University between January 2020 and December 2024. Patients were stratified into early-onset SA-AKI(E-SA-AKI, within 48 hours of sepsis diagnosis) and late-onset SA-AKI (L-SA-AKI, 48 hours-7 days post-sepsis) groups, with a maximum 5-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study found that most SA-AKI cases were early-onset (E-SA-AKI vs. L-SA-AKI: 73% vs. 27%). The median age of patients was 65 years, with 72% males. The primary infection sources were abdominal (41.9%) and pulmonary\/urinary (36.3%). The cumulative survival rates at 28 days, 90 days, 1 year, and 5 years were 50.5%, 44.8%, 38.9%, and 33.9%, respectively. Both short-term and long-term survival rates were significantly higher in E-SA-AKI patients than L-SA-AKI patients(all\n                      <jats:italic>P<\/jats:italic>\n                      \u00a0&amp;lt;\u00a00.001). Using LASSO and multivariable Cox regression analyses, a prognostic model was developed, identifying five independent predictors of one-year mortality:L-SA-AKI and septic shock as risk factors, while high albumin level, 28-day renal function recovery, and 48-hour lactate normalization as protective factors. The model\u2019s C-statistic (C-index)was 0.79, demonstrating good discrimination and calibration in both the training set [AUC (95% CI): 0.897(0.853\u20130.931)] and the validation set (AUC(95% CI): 0.909 [0.839\u20130.951)]. Decision curve analysis indicated favorable clinical utility.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The timing of SA-AKI onset is a critical prognostic stratification indicator. A one-year mortality risk nomogram model constructed based on the temporal staging, septic shock, albumin level, 28-day renal function recovery status, and 48-hour lactate normalization provides important reference for clinical decision-making.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fcimb.2026.1844250","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T05:32:57Z","timestamp":1785994377000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Development and validation of a temporal staging-based nomogram for 1-year mortality in sepsis-associated acute kidney injury"],"prefix":"10.3389","volume":"16","author":[{"given":"Jingrong","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Emergency ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaizhen","family":"Han","sequence":"additional","affiliation":[{"name":"Department of Emergency ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Pei","sequence":"additional","affiliation":[{"name":"Department of Emergency ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luanluan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Emergency ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xianfei","family":"Ding","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Henan Engineering Research Center for Critical Care Medicine, Henan Key Laboratory of Critical Care Medicine, Henan Key Laboratory of Sepsis in Health Commission, Zhengzhou Key Laboratory of Sepsis, Henan Sepsis Diagnosis and Treatment Center","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Emergency ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiafeng","family":"Xie","sequence":"additional","affiliation":[{"name":"Department of Emergency ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahui","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Emergency ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dong","family":"Xu","sequence":"additional","affiliation":[{"name":"Department of Emergency ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhiqiang","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Emergency ICU, The First Affiliated Hospital of Zhengzhou University, Zhengzhou University","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tongwen","family":"Sun","sequence":"additional","affiliation":[{"name":"Department of Critical Care Medicine, Department of Emergency Medicine, The First Affiliated Hospital of Zhengzhou University, Henan Engineering Research Center for Critical Care Medicine, Henan Key Laboratory of Critical Care Medicine, Henan Key Laboratory of Sepsis in Health Commission, Zhengzhou Key Laboratory of Sepsis, Henan Sepsis Diagnosis and Treatment Center","place":["Zhengzhou, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1007\/s00134-017-4755-7","article-title":"Acute kidney injury in sepsis","volume":"43","author":"Bellomo","year":"2017","journal-title":"Intensive Care Med."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1374740938","DOI":"10.1177\/08850666251411914","article-title":"The relationship between lactate levels and acute kidney injury risk in patients with hemorrhagic shock and septic shock: an analysis based on the mimic-iv database","author":"Chen","year":"2026","journal-title":"J. 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