{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T17:58:30Z","timestamp":1785261510218,"version":"3.55.0"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":["Kidney360"],"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Emerging evidence suggests that uremic toxins (UTs) may exacerbate organ dysfunction in septic-shock-associated AKI. However, the dynamic changes in serum concentrations of these solutes and their specific prognostic implications remain largely unexplored.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>This prospective study enrolled 114 patients with septic shock and AKI, alongside 15 non-AKI septic shock controls. We measured serum levels of seven UTs (indoxyl sulfate, indole-3-acetic acid, para-cresyl sulfate, para-cresyl glucuronide, hippuric acid, 3-carboxy-4-methyl-5-propyl-2-furanpropionate (CMPF), and trimethylamine N-oxide ) daily from Day 0 to Day 6. We analysed toxin kinetics and their relationship with 28-day mortality and the time to successful liberation from vasopressor and invasive mechanical ventilation, using joint modelling for longitudinal and survival data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Upon inclusion, 30% of patients had Stage 1, 30% Stage 2, and 40% Stage 3 AKI. Except for CMPF, all toxins accumulated significantly compared to controls and remained significantly higher in severe AKI throughout the observation period (p&lt;0.001). Indoxyl sulfate showed the strongest longitudinal correlations with serum creatinine (\n                      <jats:italic toggle=\"yes\">r<\/jats:italic>\n                      =0.67, p&lt;0.001). Daily kidney replacement therapy (KRT) status was associated with lower levels of most UTs, with the notable exceptions of indoxyl sulfate (unaffected) and hippuric acid (positively associated). Forty-four patients (39%) died within 28 days. After adjusting for baseline SAPS II and nonrenal SOFA scores, UT trajectories were not significantly associated with 28-day mortality or the time to successful liberation from organ support.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Changes in serum UT concentrations correlated with the severity and trajectory of AKI during septic shock, and exhibited variable clearance during KRT, but were not independently associated with 28-day mortality or organ support dependence.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.34067\/kid.0000001293","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T17:00:53Z","timestamp":1785258053000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Uremic Toxin Trajectories in Septic Shock-Associated Acute Kidney Injury and Patient Outcomes"],"prefix":"10.34067","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2514-4193","authenticated-orcid":false,"given":"Dimitri","family":"Titeca-Beauport","sequence":"first","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Department, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"Medical Intensive Care Department, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7343-9212","authenticated-orcid":false,"given":"Sandra","family":"Bodeau","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Centre for Human Biology, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6210-2270","authenticated-orcid":false,"given":"Cl\u00e9ment","family":"Brault","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Department, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Momar","family":"Diouf","sequence":"additional","affiliation":[{"name":"Department of Statistics, Clinical Research and Innovation Directorate Amiens-Picardie University Medical Centre, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Touria","family":"Mernissi","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Centre for Human Biology, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-6346-6809","authenticated-orcid":false,"given":"Camille","family":"Andr\u00e9","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Centre for Human Biology, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0827-4746","authenticated-orcid":false,"given":"Olivier","family":"Varennes","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Centre for Human Biology, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5195-2584","authenticated-orcid":false,"given":"Charlotte","family":"Durand-Maugard","sequence":"additional","affiliation":[{"name":"Department of Biochemistry, Centre for Human Biology, Amiens-Picardie University Medical Centre, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Lambour","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Department, Amiens-Picardie University Medical Centre, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoann","family":"Zerbib","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Department, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loay","family":"Kontar","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Department, Amiens-Picardie University Medical Centre, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel","family":"Slama","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Department, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0186-4797","authenticated-orcid":false,"given":"Youssef","family":"Bennis","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, Centre for Human Biology, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabriel","family":"Choukroun","sequence":"additional","affiliation":[{"name":"Nephrology, Dialysis and Transplantation Department, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Maizel","sequence":"additional","affiliation":[{"name":"Medical Intensive Care Department, Amiens-Picardie University Medical Centre, Amiens, France."},{"name":"MP3CV Laboratory, UR 7517, Jules Verne University of Picardie, Amiens, France."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2026,7,28]]},"container-title":["Kidney360"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T17:00:53Z","timestamp":1785258053000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.34067\/KID.0000001293"}},"subtitle":["The Tox-AKI Study"],"short-title":[],"issued":{"date-parts":[[2026,7,28]]},"references-count":0,"URL":"https:\/\/doi.org\/10.34067\/kid.0000001293","relation":{},"ISSN":["2641-7650"],"issn-type":[{"value":"2641-7650","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,28]]},"assertion":[{"value":"2026-02-23","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}