{
  "abstract": "Background: The duration of continuous kidney replacement therapy (CKRT) represents a complex clinical surrogate reflecting the severity of systemic illness, the rate of metabolic recovery, and clinical decision-making regarding treatment discontinuation. The effect of CKRT duration on long-term outcomes in patients with acute kidney injury (AKI) is unclear. This study aimed to identify factors associated with CKRT duration and evaluate its association with long-term renal outcomes and mortality.\n\nMethods: This multicenter, retrospective study included 1,436 patients with AKI who received CKRT between 2017 and 2022 and survived ≥ 3 months post-initiation. Participants were stratified into groups based on the median CKRT duration: short (≤ 4 days) or long duration (> 4 days). Multivariable logistic regression examined the factors associated with CKRT duration. Multivariable Cox proportional hazards regression evaluated the effect of CKRT duration on the risk of end-stage kidney disease (ESKD) and all-cause mortality. The incremental predictive value of CKRT duration beyond traditional clinical variables and the Sequential Organ Failure Assessment (SOFA) score was evaluated using differences in Harrell’s concordance index (ΔC-index), net reclassification improvement (NRI), and integrated discrimination improvement (IDI).\n\nResults: The use of mechanical ventilation (adjusted odds ratio [aOR], 2.742; 95% confidence interval [CI], 1.990 − 3.792; P < 0.001), extracorporeal membrane oxygenation (aOR, 1.983; 95% CI, 1.223 − 3.267; P = 0.006), and higher C-reactive protein levels (aOR, 1.002; 95% CI, 1.001–1.004; P = 0.009) were significant predictors of long-duration CKRT. However, higher baseline urine output (aOR, 0.998; 95% CI, 0.996–1.000; P = 0.017) and platelet counts (aOR, 0.998; 95% CI, 0.996–0.999; P = 0.009) were independently associated with short-duration CKRT. During a mean follow-up of 17.8 months and 24.6 months, 26.1% of participants progressed to ESKD and 26.6% died, respectively. After adjusting for confounders, long-duration CKRT was independently associated with a significantly higher risk of ESKD (adjusted hazard ratio [aHR], 1.598; 95% CI, 1.260–2.025; P < 0.001) and all-cause mortality (aHR, 1.631; 95% CI, 1.310–2.032; P < 0.001). Addition of CKRT duration to baseline risk models including the SOFA score significantly enhanced risk reclassification and discrimination performance for both ESKD (ΔC-index = + 0.020, P < 0.001; NRI = 30.0%, P < 0.001; IDI = 0.024, P < 0.001) and all-cause mortality (ΔC-index = + 0.037, P < 0.001; NRI = 33.0%, P < 0.001; IDI = 0.033, P = 0.030).\n\nConclusions: Prolonged CKRT was independently associated with an increased risk of long-term ESKD progression and all-cause mortality among 3-month survivors of AKI. Thus, the duration of CKRT may serve as a meaningful prognostic marker to identify high-risk patients who might benefit from close follow-up and tailored multidisciplinary management.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, Daegu, Republic of Korea",
    "Division of Nephrology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Kyungpook National University Hospital, 130 Dongdeok-ro, Jung-gu, Daegu, 41944 Republic of Korea",
    "Department of Statistics, Kyungpook National University, Daegu, Republic of Korea",
    "Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Republic of Korea",
    "Department of Internal Medicine, Seoul National University Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea",
    "Department of Internal Medicine, Keimyung University School of Medicine, Daegu, Republic of Korea",
    "Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul, Republic of Korea",
    "Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea",
    "Department of Internal Medicine, The Catholic University of Korea, Yeouido St. Mary’s Hospital, Seoul, Republic of Korea",
    "Department of Internal Medicine, Hallym University Sacred Heart Hospital, Anyang, Republic of Korea"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 22,
  "authors": [
    {
      "affs": [
        0,
        1
      ],
      "name": "Hee-Yeon Jung",
      "orcid": "0000-0003-0232-7202"
    },
    {
      "affs": [
        2
      ],
      "name": "Junyoung Park"
    },
    {
      "affs": [
        3
      ],
      "name": "Donghwan Yun"
    },
    {
      "affs": [
        3
      ],
      "name": "Seung Seok Han"
    },
    {
      "affs": [
        3
      ],
      "name": "Dong Ki Kim"
    },
    {
      "affs": [
        4
      ],
      "name": "Jeonghwan Lee"
    },
    {
      "affs": [
        4
      ],
      "name": "Jung Pyo Lee"
    },
    {
      "affs": [
        5
      ],
      "name": "Yaerim Kim"
    },
    {
      "affs": [
        5
      ],
      "name": "Kyubok Jin"
    },
    {
      "affs": [
        6
      ],
      "name": "Ji Eun Kim"
    },
    {
      "affs": [
        6
      ],
      "name": "Gang-Jee Ko"
    },
    {
      "affs": [
        7
      ],
      "name": "Shin Young Ahn"
    },
    {
      "affs": [
        7
      ],
      "name": "Seokwoo Park"
    },
    {
      "affs": [
        7
      ],
      "name": "Sejoong Kim"
    },
    {
      "affs": [
        8
      ],
      "name": "Eun Sil Koh"
    },
    {
      "affs": [
        8
      ],
      "name": "Sungjin Chung"
    },
    {
      "affs": [
        0
      ],
      "name": "Jang-Hee Cho"
    },
    {
      "affs": [
        0
      ],
      "name": "Sun-Hee Park"
    },
    {
      "affs": [
        0
      ],
      "name": "Chan-Duck Kim"
    },
    {
      "affs": [
        0
      ],
      "name": "Yong-Lim Kim"
    },
    {
      "affs": [
        9
      ],
      "name": "Sung Gyun Kim"
    },
    {
      "affs": [
        9
      ],
      "name": "Jung Nam An"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/88h54mk66qy5d.bib",
  "cited_by": 0,
  "doi": "10.1186/s12882-026-05376-0",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13711906/",
  "id": "88h54mk66qy5d",
  "issns": [
    "1471-2369"
  ],
  "landing_url": "https://doi.org/10.1186/s12882-026-05376-0",
  "language": "en",
  "licence": "CC-BY-NC-ND-4.0",
  "licence_label": "CC BY-NC-ND 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research"
    ],
    [
      "openalex",
      "2727|Acute Kidney Injury Research"
    ]
  ],
  "openalex": "W7213980813",
  "pdf_url": "https://link.springer.com/content/pdf/10.1186/s12882-026-05376-0.pdf",
  "pmcid": "PMC13711906",
  "pmid": "42947034",
  "published": "2026-09-22",
  "publisher": "BMC",
  "ris": "https://research.draconitic.com/paper/88h54mk66qy5d.ris",
  "sources": [
    {
      "first_seen": "2026-10-31T12:22:36Z",
      "native_id": "PMC13711906",
      "source": "pmc",
      "url": "https://doi.org/10.1186/s12882-026-05376-0"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2727|Acute Kidney Injury Research",
      "subfield": "general"
    }
  ],
  "title": "Prognostic implications of the duration of continuous kidney replacement therapy in 3-month survivors of acute kidney injury: findings from the LINKA cohort",
  "title_text": "Prognostic implications of the duration of continuous kidney replacement therapy in 3-month survivors of acute kidney injury: findings from the LINKA cohort",
  "type": "peer-reviewed",
  "updated_at": "2026-10-31T12:22:36Z",
  "url": "https://research.draconitic.com/paper/88h54mk66qy5d",
  "venue": "BMC Nephrology",
  "versions": []
}