{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:02:51Z","timestamp":1784872971766,"version":"3.55.0"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T00:00:00Z","timestamp":1784851200000},"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. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The optimal treatment for patients with pneumonia complicated by acute kidney injury (AKI) remains challenging. This study aims to investigate the clinical efficacy and safety of combining ulinastatin with continuous renal replacement therapy (CRRT) in these patients, thereby providing evidence for clinical treatment planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This retrospective study included 100 patients with pneumonia complicated by AKI admitted to our hospital from January 2019 to December 2024. The assignment of patients to treatment groups was based on the regimens recorded in the electronic medical record system, as determined by the treating physicians. Patients were divided into a combination group (\n                      <jats:italic>n<\/jats:italic>\n                      =\u202f49, ulinastatin plus CRRT) and a CRRT group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f51, CRRT alone). We compared post-treatment levels of inflammatory markers (interleukin [IL]-6, IL-8, C-reactive protein [CRP], tumor necrosis factor-alpha [TNF-\n                      <jats:italic>\u03b1<\/jats:italic>\n                      ]), renal function indicators (cystatin C [CysC], blood urea nitrogen [BUN], serum creatinine [Cr]), pulmonary function indicators (maximal expiratory pressure [PEmax], maximal inspiratory pressure [Plmax], peak expiratory flow [PEF]), urine pH, and 24-h urine output between the two groups. The overall clinical response rate was also compared.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Post-treatment, both groups demonstrated significantly improved levels of inflammatory markers, renal function, pulmonary function, urine pH, and 24-h urine output compared to pre-treatment (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Compared to the CRRT group, the combination therapy group exhibited significantly lower post-treatment levels of IL-6 (69.43\u202f\u00b1\u202f19.35 vs. 81.24\u202f\u00b1\u202f18.21\u202fpg.\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), IL-8 (148.49\u202f\u00b1\u202f34.26 vs. 167.92\u202f\u00b1\u202f41.44\u202fpg.\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), CRP (81.66\u202f\u00b1\u202f15.51 vs. 92.19\u202f\u00b1\u202f17.23\u202fmg\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), TNF-\n                      <jats:italic>\u03b1<\/jats:italic>\n                      (103.38\u202f\u00b1\u202f28.51 vs. 123.36\u202f\u00b1\u202f33.22\u202fpg.\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), BUN (7.11\u202f\u00b1\u202f2.53 vs. 8.54\u202f\u00b1\u202f3.81\u202fmmol\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), and Cr (115.45\u202f\u00b1\u202f28.99 vs. 131.37\u202f\u00b1\u202f35.14\u202f\u03bcmol\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05). Post-treatment levels of CysC (8.39\u202f\u00b1\u202f3.85 vs. 6.13\u202f\u00b1\u202f2.72\u202fmg\/L,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), PEmax (43.71\u202f\u00b1\u202f5.22 vs. 35.96\u202f\u00b1\u202f5.40%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), Plmax (83.34\u202f\u00b1\u202f7.50 vs. 70.88\u202f\u00b1\u202f6.56%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), PEF (1.57\u202f\u00b1\u202f0.23 vs. 1.30\u202f\u00b1\u202f0.16\u202fL\u00b7s\n                      <jats:sup>\u22121<\/jats:sup>\n                      , p\u202f&amp;lt;\u202f0.05), urine pH (6.80\u202f\u00b1\u202f1.03 vs. 6.28\u202f\u00b1\u202f1.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.05), and 24-h urine output (1.90\u202f\u00b1\u202f0.22 vs. 1.79\u202f\u00b1\u202f0.21\u202fL\/24\u202fh, p\u202f&amp;lt;\u202f0.05) were significantly higher in the combination group. The overall clinical response rate in the combination group (47\/49, 95.92%) was significantly higher than that in the CRRT group (42\/51, 82.35%) (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.03).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The combination of ulinastatin and CRRT may offer additional benefits over CRRT alone in improving clinical symptoms, inflammatory markers, renal function, and pulmonary function in patients with pneumonia complicated by AKI. However, given the retrospective nature of this study, these findings should be considered preliminary and require confirmation in large-scale, prospective, randomized controlled trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1775153","type":"journal-article","created":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T05:36:35Z","timestamp":1784871395000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment protocol for pneumonia with acute kidney injury: effects of ulinastatin combined with CRRT on inflammatory factors and renal function in patients"],"prefix":"10.3389","volume":"13","author":[{"given":"Li","family":"Bai","sequence":"first","affiliation":[{"name":"Department of Nephrology, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuai","family":"Luo","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiang","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Chongming Hospital Affiliated to Shanghai University of Medicine and Health Sciences","place":["Shanghai, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"2020","DOI":"10.1016\/j.jiph.2020.10.007","article-title":"Myositis and acute kidney injury in bacterial atypical pneumonia: systematic literature review","volume":"13","author":"Simoni","year":"2020","journal-title":"J Infect Public 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