Objective  To investigate the efficacy and prognosis of the endotoxin-adsorbing (oXiris) hemofilter in patients with septic shock-associated acute kidney injury (AKI).  Methods  A retrospective observational study was conducted on 65 patients with AKI caused by septic shock in the Department of Critical Care Medicine, Lanzhou University Second Hospital, from January 2024 to June 2025. The patients were divided into an oXiris group (32 cases) and an ST150 group (33 cases). Laboratory tests and clinical indicators were collected upon admission. Circulatory parameters, vasoactive agent dosages, and infection markers were compared between the two groups before (0 h) and after (24 h) continuous renal replacement therapy (CRRT). Kaplan-Meier survival curves were used to analyze 14-day and 28-day outcomes.  Results  ①Compared with the ST150 group, the oXiris group had higher D-dimer (Z=-2.605, P = 0.009) and aspartate aminotransferase (Z = -2.382, P = 0.017), and lower platelet count (Z=-2.454, P =0.014). ② Pulmonary infection was common in both groups [7(21.9%) vs. 13(39.4%), χ²=2.314, P=0.126], and Gram-negative bacilli predominated, mainly Escherichia coli [8(25.0%) vs. 8(24.2%), χ²=0.005, P=0.943]. ③ Compared with the ST150 group, the oXiris group had a higher norepinephrine dosage before treatment (0 h) (Z=-2.565, P=0.010); after 24 h, the oXiris group had lower procalcitonin (Z=-2.232, P=0.026) and interleukin-6 levels (Z=-2.115, P=0.034). ④Kaplan-Meier survival curve analysis showed no statistically significant differences in 14-day and 28-day cumulative survival rates between two groups (χ²=0.275, P=0.600; χ²=0.099, P=0.753). Conclusion  oXiris has significant advantages in stabilizing hemodynamics and clearing inflammatory factors in patients with high vasoactive agent requirements, but it does not improve short-term or medium-term prognosis.