Germany: A large retrospective analysis has revealed thatacute kidney injury (AKI)is a common and serious complication in patients receivingveno-venous extracorporeal membrane oxygenation (VV-ECMO)for acuterespiratory failure, with severe forms linked to lower chances of hospital survival regardless of when the injury occurs. The study was published online inKidney360on August 1, 2025. The study, led by Clemens Wiest and colleagues from the University Hospital Regensburg in Germany, examined outcomes in 500 patients who underwent VV-ECMO between November 2014 and December 2021. The median age was 55 years, and women made up 30% of the cohort. Overall, 64% of patients developed AKI during their hospital stay. Among them, 182 patients had kidney injury before starting ECMO, while 158 developed it during ECMO therapy. A smaller subgroup experienced AKI both before ECMO and again after an initial recovery. The key findings of the study were as follows: The authors noted that while ECMO is a life-saving intervention for severe respiratory failure, the occurrence of AKI signals a more critical underlying disease state and is an important prognostic indicator. They wrote, “AKI onset before VV-ECMO therapy is linked to the severity of the underlying disease. AKI onset during VV-ECMO is less due to ECMO-related factors but also to the severity of the disease and septic episodes.” The findings underscore the importance of early recognition and management of AKI risk in ECMO patients, with close monitoring for signs of sepsis and hemodynamic instability. Preventive strategies, timely interventions, and tailored post-ECMO follow-up could help improve patient outcomes. Fuchs, Franziska1,*; Wiest, Clemens1,*,#; Philipp, Alois2; Foltan, Maik2; Schneckenpointner, Roland1; Dietl, Alexander1; Lunz, Dirk3; Fisser, Christoph1; Müller, Thomas1; Lubnow, Matthias1. Acute Kidney Injury in Patients With Veno-venous Extracorporeal Membrane Oxygenation: An Observational Retrospective Analysis of Risk-factors and Outcome. Kidney360 ():10.34067/KID.0000000920, August 1, 2025. | DOI: 10.34067/KID.0000000920