Highlight
– A systematic review of randomized trials (McDonald et al., 2025) found no conclusive benefit of any specific vasopressor on incidence of acute kidney injury (AKI) in septic shock.
– Reporting was heterogeneous: only 8/17 trials reported AKI incidence using KDIGO/AKIN or undefined criteria; RRT use was the most common renal outcome but inconsistently defined.
– Existing evidence is underpowered and methodologically limited; future trials should standardize renal endpoints (KDIGO/MAKE), target subgroups at high renal risk, and include longer-term kidney outcomes.
