Abstract: SA-PO0027
AKI in Patients with Babesiosis
Session Information
- Top Trainee Posters - 3
November 08, 2025 | Location: Exhibit Hall, Convention Center
Abstract Time: 01:36 PM - 01:42 PM
Category: Acute Kidney Injury
- 101 AKI: Epidemiology, Risk Factors, and Prevention
Authors
- Monson, Audrey, Brigham and Women's Hospital, Boston, Massachusetts, United States
- Krause, Peter James, Yale School of Medicine, New Haven, Connecticut, United States
- Leaf, David E., Brigham and Women's Hospital, Boston, Massachusetts, United States
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 performed a multicenter cohort study of 3,214 consecutive adults hospitalized with babesiosis at 84 hospitals from 24 medical centers across 8 states in the northeastern US from 2010 to 2024. Data on demographics, comorbidities, vital signs, physiologic parameters, labs, treatments, and outcomes were collected by detailed chart review. We sought to identify the incidence and predictors of moderate-to-severe AKI, defined as a ≥2-fold increase in serum creatinine (SCr) above baseline or receipt of kidney replacement therapy (KRT), along with its association with Major Adverse Kidney Events at 90 days (MAKE90). The latter was defined as death, persistent KRT-dependence, or a ≥2-fold increase in SCr above baseline at 90 days post-discharge.
Results
A total of 313 patients (9.7%) developed moderate-to-severe AKI. Higher parasitemia burden, LDH, total bilirubin, and lower serum albumin on admission were each associated with a higher odds of moderate-to-severe AKI (Figure 2A). Eleven independent risk factors for moderate-to-severe AKI were identified (Figure 2B), with systolic blood pressure, serum albumin, LDH, and 3+ dipstick hematuria having the highest relative importance (Figure 2C). MAKE90 occurred in 58.3% of patients with moderate-to-severe AKI compared to 4.9% of those without.
Conclusion
Nearly 10% of hospitalized patients with babesiosis developed moderate-to-severe AKI, over half of whom had persistent kidney dysfunction or death at day 90. Independent risk factors for AKI included markers of hemolysis and severity of parasitemia.