144 Chapter 7 Abstract Acute kidney injury (AKI) is a frequent complication in patients with Staphylococcus aureus bacteremia (SAB), with a significant impact on patient management and outcome. This study aimed to provide insight in the proportion of patients with SAB that develop AKI, the risk factors for developing AKI in this population, and its reversibility. In this retrospective, multicenter cohort study, adult patients with SAB were eligible for inclusion. Patient characteristics, clinical variables, and laboratory results were retrieved from the electronic patient files. Primary outcome was development of AKI, defined as 1.5 times baseline creatinine. Secondary outcomes were reversibility of AKI and risk factors for AKI. A total of 315 patients with SAB were included, of whom 115/315 (37%) developed acute kidney injury. In 68/115 (59%), the AKI was reversible. If kidney function recovered, this occurred within 7 days in 56/68 (82%) of patients. In multivariable logistic regression analyses, independent risk factors for AKI were as follows: complicated SAB, use of diuretics, and hemodynamic instability. Development of AKI was associated with 30-day mortality (OR 3.9; CI 2.2–6.9; p < 0.01). Acute kidney injury is a frequent complication in patients with Staphylococcus aureus bacteremia. Considering the irreversibility in a relevant proportion of patients, future research into the underlying pathophysiology and potential interventions is warranted. Introduction Staphylococcus aureus is a major cause of bloodstream infections and is associated with high morbidity and mortality rates [1, 2]. Acute kidney injury (AKI) is a frequent complication in patients with Staphylococcus aureus bacteremia (SAB), with a significant impact on patient management and outcome [3, 4]. The etiology of AKI in SAB is diverse, including prerenal, toxic/drug-related, immune-mediated, tubulointerstitial nephritis (TIN), acute tubular necrosis (ATN), and postrenal pathophysiology. Despite the fact that acute kidney injury in patients with SAB is common, little is known about the proportion of patients with SAB that develop AKI, the risk factors for developing AKI in these patients, and its reversibility. The SAB patient population is heterogeneous, and the disease course varies greatly, from transient bacteremia in uncomplicated SAB to widespread infection and metastatic disease in complicated SAB [5]. Although likely on theoretical grounds, it is unknown whether the incidence, etiology, and outcome of AKI differ between complicated and uncomplicated SAB [6]. The aim of this study was to investigate the incidence of AKI in SAB, its reversibility, the risk factors for the development of AKI, and differences in disease course
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