Acute kidney injury during invasive listeriosis: frequence, risk factors, and prognostic impact in a multicenter cohort (REALIST study).

OBJECTIVE

Invasive listeriosis carries high mortality, and acute kidney injury (AKI) may complicate hospitalization and worsen outcomes. However, its incidence, risk factors, and prognostic impact in this setting remain poorly described. We aimed to evaluate AKI in patients hospitalized for invasive listeriosis.

METHODS

We conducted a retrospective multicenter cohort study including adults with microbiologically confirmed invasive listeriosis across six French university hospitals (2010-2023). AKI within 14 days was defined according to modified KDIGO criteria as a ≥ 1.5-fold increase in serum creatinine from admission value to peak during the first 14 days. Data included comorbidities, exposures, treatment, renal recovery, and mortality. AKI predictors were assessed using multivariable Cox regression.

RESULTS

Among 150 patients (median age 76 years), 31% developed AKI within 14 days. In multivariable analysis, hypertension (HR: 6.60; 95% CI: 2.00-21.77; P = 0.002) and qSOFA ≥1 (HR: 2.90; 95% CI: 1.41-5.94; P = 0.003) were independently associated with AKI. Gentamicin-based therapy was not associated with AKI. AKI was associated with higher 30-day and 90-day mortality (37% vs 18% and 56% vs 24%, respectively; P < 0.001).

CONCLUSIONS

AKI is frequent in listeriosis and associated with increased mortality. These findings highlight the importance of early risk stratification and renal monitoring in this population.