Kidney Week

Abstract: FR-PO055

AKI in Patients with Babesiosis: Incidence, Risk Factors, Clinical Features, and Outcomes

Session Information

• AKI: Epidemiology, Risk Factors, and Prevention - 2
  October 25, 2024 | Location: Exhibit Hall, Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: Acute Kidney Injury

• 101 AKI: Epidemiology, Risk Factors, and Prevention

Authors

• Monson, Audrey E., Mass General Brigham Inc, Boston, Massachusetts, United States

Audrey E. Monson, MS, MSc

• Baigorri, Julio, Mass General Brigham Inc, Boston, Massachusetts, United States

Julio Baigorri

• Jaser, Ahmad, Mass General Brigham Inc, Boston, Massachusetts, United States

Ahmad Jaser, MD

• Kaunfer, Sarah Allison, Mass General Brigham Inc, Boston, Massachusetts, United States

Sarah Allison Kaunfer

• Krishnamurthy, Shobana, Mass General Brigham Inc, Boston, Massachusetts, United States

Shobana Krishnamurthy, MBBS

• Socorro Matos, Guillermo, Mass General Brigham Inc, Boston, Massachusetts, United States

Guillermo Socorro Matos

• Krause, Peter James, Yale New Haven Health System, New Haven, Connecticut, United States

Peter James Krause, MD

• Leaf, David E., Mass General Brigham Inc, Boston, Massachusetts, United States

David E. Leaf, MD, MS, MSc, FASN

Background

Babesiosis is an emerging tickborne illness caused by the intraerythrocytic parasite, Babesia microti, which is endemic in the northeastern U.S. Complications have been observed in >20% of hospitalized patients, though AKI remains poorly described, with most data derived from case reports and small case series.

Methods

We reviewed the records of 1317 patients at Mass General Brigham with an ICD code or positive test result for Babesia between 2015-2023, of whom 272 (20.7%) were hospitalized. Among those hospitalized, we collected detailed data by manual chart review on demographics, comorbidities, medications, labs, and outcomes. We sought to characterize the incidence, severity, clinical features, risk factors, and outcomes of AKI, defined as a ≥50% increase in serum creatinine above baseline or receipt of kidney replacement therapy (KRT). We used multivariable logistic regression to identify independent risk factors for AKI.

Results

A total of 93 patients (34.2%) developed AKI, including 52 (55.9%), 23 (24.7%), and 18 (19.4%) with stages 1, 2, and 3 (Fig. 1A), 7 of whom (7.5%) received KRT. The most common etiologies of AKI were ATN, pre-renal azotemia, and hemolysis (Fig. 1B). Independent risk factors for AKI included older age, smoking, higher LDH, higher parasitemia load, and hematuria (Fig. 1C). Eight of 50 patients (16%) with data available had persistent kidney dysfunction at day 90.

Conclusion

In the largest study to date, we found that more than one third of hospitalized patients with babesiosis developed AKI, nearly half of which was stage 2 or 3. We identified five independent risk factors for AKI, including markers of hemolysis and severity of parasitemia.