TOPLINE

Adults hospitalized with Salmonella enteritis had more than three times the risk for acute kidney injury (AKI) compared with those hospitalized with Campylobacter enteritis, with 41.8% of patients in the Salmonella group developing AKI stages 2 and 3.

METHODOLOGY

• Researchers conducted a retrospective cohort study of 232 adults hospitalized with community-acquired bacterial gastroenteritis at a tertiary center in South Korea from 2018 to 2025.
• A total of 139 patients had Campylobacter infection, 55 had Salmonella infection, and 38 had other bacterial infections (Escherichia coli or Clostridioides difficile).
• The primary outcome was AKI, defined based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria as increase in serum creatinine (Cr) levels of ≥ 0.3 mg/dL within 48 hours or ≥ 1.5× from baseline, staged as 1, 2, or 3 based on specified criteria.
• Associations between pathogen type and risk for AKI were assessed using multivariable logistic regression, with the Campylobacter group as the reference group.
• Composite postdischarge kidney outcomes comprised acute kidney disease (AKD, assessed in patients with follow-up < 3 months, defined as estimated glomerular filtration rate [eGFR] < 60 mL/min/1.73 m², eGFR decline ≥ 50% from baseline, or serum Cr ≥ 1.5× baseline), incident chronic kidney disease (CKD, defined as eGFR < 60 mL/min/1.73 m² persisting beyond 3 months in patients without preexisting CKD), and CKD progression (eGFR decline ≥ 50% from baseline or progression to a lower eGFR category in patients with preexisting CKD).

TAKEAWAY

• AKI incidence differed significantly across pathogen groups: 26.6% in the Campylobacter group, 70.9% in the Salmonella group, and 31.6% in the other infections group (P < .001), with the combined incidence of AKI stages 2 and 3 markedly higher in the Salmonella group (41.8%).
• Salmonella enteritis was independently associated with higher risk for AKI compared with Campylobacter (adjusted odds ratio [aOR], 3.19; P = .017).
• The median length of hospital stay was longer in the Salmonella group than in the Campylobacter group (8.0 vs 5.0 days; adjusted incidence rate ratio, 1.17; 95% CI, 1.03-1.34).
• In-hospital AKI was independently associated with postdischarge composite kidney outcome (adjusted hazard ratio [HR], 3.20; P = .045); among 65 patients who recovered from AKI before discharge, 16.9% subsequently developed AKD or CKD.

IN PRACTICE

"These findings support pathogen-specific risk stratification — specifically, closer renal monitoring and prompt fluid resuscitation in patients with Salmonella infection — and highlight the need for continued postdischarge kidney function monitoring for those who develop in-hospital AKI," the authors of the study wrote.

SOURCE

The study was led by Hyeon Woo, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine in Changwon, Republic of Korea. It was published online on July 25 in Open Forum Infectious Diseases.

LIMITATIONS

As a retrospective single-center study, findings may not generalize to other settings. Baseline Cr values prior to admission were available in only 61.2% of patients; for the remainder, in-hospital nadir Cr was used as baseline. Certain potentially relevant variables were not systematically captured. The modest sample size, particularly in the Salmonella and other infection groups, limited the precision of effect estimates and subgroup analyses.

DISCLOSURES

No specific funding was reported in this study. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.