Critical care nephrology is evolving from a discipline focused primarily on acute organ support toward an integrated framework encompassing mechanistic insights, precision-based clinical decision-making, and long-term risk management. Advances reported in 2025 have further expanded the understanding of acute kidney injury (AKI) pathogenesis, with metabolic reprogramming, ferroptosis, epigenetic regulation, and immune-inflammatory networks emerging as major research priorities and potential therapeutic targets. Clinical management is becoming increasingly individualized and precise. AKI subphenotyping is facilitating stratified therapeutic strategies, while decisions regarding the initiation of continuous renal replacement therapy (CRRT) are shifting toward more cautious and patient-specific approaches. Fluid management strategies are being refined through the integration of artificial intelligence and the concept of hemodynamic coupling. In addition, management of cardiorenal syndrome (CRS) increasingly emphasizes multi-organ coordination and the application of novel therapeutic agents. Long-term follow-up studies have confirmed that AKI is a significant risk factor for chronic kidney disease (CKD) progression, leading to broad recognition of the "AKI-to-CKD continuum" as a key concept in patient management. Future progress in critical care nephrology will depend on the translation of mechanistic discoveries into clinical practice, validation through multicenter randomized controlled trials, and the establishment of multidisciplinary, continuum-of-care models. This paper provides a systematic review of related research to offer reference for future research directions and clinical practice.