Early Endotoxin Burden Reduction With oXiris in Septic Shock Patients Requiring CRRT

Inclusion Criteria: * Age 18 years or older. * Diagnosis of septic shock according to Sepsis-3 criteria: sepsis with persistent hypotension requiring vasopressors to maintain a mean arterial pressure of at least 65 mmHg and a blood lactate level greater than 2 mmol/L despite adequate fluid resuscitation. * Acute kidney injury classified as KDIGO stage 2 or 3. * A clinical decision by the treating team to initiate continuous renal replacement therapy (CRRT). Exclusion Criteria: * The decision to initiate CRRT was made 24 hours or more before enrollment. * A documented decision to limit life-sustaining treatment or not to pursue invasive treatment. * Active major bleeding, a major bleeding event within the previous 48 hours, or severe uncorrected bleeding tendency. * Confirmed or suspected heparin-induced thrombocytopenia, or a known severe allergy to heparin or the filter materials. * Severe irreversible end-stage organ failure with an expected survival of 48 hours or less. * Pregnancy or breastfeeding. * Participation within the previous 6 months in another interventional study that may affect the outcomes of this study. * Written informed consent not obtained from the participant or legally authorized representative.