ArticleFrontiers in medicine2026
Timing of renal replacement therapy in acute kidney injury after liver transplantation: the clinical value of the NMF standards.
Article in Frontiers in medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Objective: To evaluate the utility of the NMF standards-comprising intraoperative norepinephrine dosage, preoperative MELD-Na score, and total intraoperative fluid intake-in determining the optimal timing for initiating renal replacement therapy (RRT) in patients with acute kidney injury (AKI) following liver transplantation. Methods: The NMF standards were developed and validated in two studies: (1) a retrospective cohort study (2018-2023, 189 patients with KDIGO stage 2 AKI) stratified by NMF status and RRT timing into four groups (A, B, C, D); and (2) a historically controlled cohort study (2024-2025, 76 NMF-guided patients vs. 189 historical controls managed by clinical judgment). The primary outcomes included renal function indicators, hospital stay, CKD incidence, and long-term RRT dependence. Results: The NMF standards have been validated as a robust clinical tool: intraoperative norepinephrine ≥6.5 μg·kg Conclusions: The NMF standards, integrated with a user-friendly WeChat mini-program, provide a validated and practical framework for optimizing RRT timing in AKI post-liver transplantation. This tool enhances clinical decision-making, reduces complications, and improves long-term renal outcomes.
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