ORIGINAL RESEARCH article
Front. Nephrol.
Sec. Clinical Research in Nephrology
This article is part of the Research TopicExtracorporeal Organ Support: Innovations and Challenges in Critical CareView all 15 articles
Use of oXiris® Hemoadsorption in Sepsis and Acute Kidney Injury: A Retrospective Cohort Study in a Resource-Limited Colombian ICU.
Provisionally accepted
David Andrés Ballesteros Castro1*
Andrea Cristina Mantilla Villarreal1Sandra Cecilia Narváez Martínez1Isabel Saravia2Susan Martínez3- 1University Hospital San José, University of Cauca, Popayán, Colombia
- 2Medical Department Vantive, Bogotá D.C, Colombia
- 3EpiThink Health Consulting SAS, Bogotá D.C, Colombia
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Background: Septic shock with acute kidney injury (AKI) carries high mortality in resource-limited settings. The oXiris® membrane enables continuous renal replacement therapy (CRRT) with endotoxin and cytokine adsorption, but data from low- and middle-income countries are scarce. Methods: We conducted a single-center retrospective cohort of adults with septic shock and KDIGO stage 2–3 AKI treated with CRRT using oXiris® in a Colombian public tertiary hospital (January 2021–March 2023). The primary outcome was renal recovery, defined as dialysis independence at discharge. Secondary outcomes included in-hospital mortality, vasopressor trajectories and hemodynamics over 72 hours, intensive care unit (ICU) length of stay, and outcomes stratified by COVID-19 status. Results: Fifty patients were analyzed (median age 56.5 [IQR 46.0–66.0] years; 32% male); 21 (42%) had confirmed SARS-CoV-2 infection. Norepinephrine requirements fell from 0.303 to 0.000 µg/kg/min over 72 hours (p<0.001), and vasopressin use declined to zero (p<0.001), while mean arterial pressure increased from 74.5 to 83.0 mmHg. In-hospital mortality was 62% (31/50) and was higher in patients with greater baseline severity (APACHE II 21.5 vs 14.5 in survivors; p=0.023). ICU length of stay was 14.0 days [5.0–22.5] and was longer in survivors than non-survivors (21.0 vs 8.0 days; p<0.001). Among survivors, 63% (12/19) were dialysis-independent at discharge. COVID-19 septic shock was associated with higher crude mortality (76% vs 52%) and lower renal recovery among survivors (9.5% vs 34%) compared with non-COVID sepsis. Conclusions: In a resource-limited ICU, oXiris®-based CRRT was associated with rapid vasopressor de-escalation and clinically meaningful kidney recovery among survivors, but overall mortality remained high and severity-dependent. COVID-19 septic shock showed a distinct profile, with higher baseline severity, a trend toward higher mortality, and impaired renal recovery. These data support feasibility and safety of hemoadsorptive CRRT in constrained settings and justify prospective comparative evaluation
Keywords: septic shock, Acute Kidney Injury, Renal Replacement Therapy, Hemoperfusion, COVID-19, Developing Countries, Hospital Mortality
Received: 13 May 2025; Accepted: 28 Nov 2025.
Copyright: © 2025 Ballesteros Castro, Mantilla Villarreal, Narváez Martínez, Saravia and Martínez. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: David Andrés Ballesteros Castro
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