Objectives: Sepsis-associated acute kidney injury (SA-AKI) is a major global health burden associated with high mortality. Although continuous kidney replacement therapy (CKRT) is widely used, strategies aimed at increasing convection volume have shown limited efficacy in removing middle molecules. The recently developed oXiris filter enables adsorption of inflammatory mediators; however, clinical evidence regarding its impact on patient outcomes remains limited and inconclusive. Therefore, we aimed to evaluate the clinical effectiveness of the oXiris hemoadsorption compared with standard CKRT in patients with SA-AKI using propensity score matching (PSM). Methods: We retrospectively identified adult patients with SA-AKI who received CKRT between 2010 and 2024 at Severance Hospital. Before matching, 6,699 patients received standard CKRT, while 39 received the oXiris filter. PSM was performed based on age and APACHE score, with exact matching for sex and APACHE severity categories. This yielded a matched cohort of 234 patients (oXiris, n=39; control, n=195). The primary outcome was in-hospital mortality, and 7-day and 28-day mortality were considered secondary outcomes. Kaplan–Meier analysis and Cox proportional hazards models were used to compare survival between the groups. Results: After PSM, baseline characteristics were well balanced, with all standardized mean differences below 0.1. Despite a trend favoring the oXiris group, there was no significant difference in in-hospital mortality between the two groups (hazard ratio [HR], 0.87; 95% confidence interval [CI], 0.56–1.35; p=0.49). The differences in 7-day and 28-day mortality also did not reach statistical significance. Conclusion: In this study, oXiris use was not associated with a statistically significant reduction in short-term mortality. However, the consistent direction of effect suggests a potential clinical benefit. Given the limited sample size and observational design, further prospective and adequately powered studies are warranted to identify patient subgroups, particularly those with septic shock or hyperinflammatory phenotypes, who may benefit from adsorption-based therapies.