Format

Send to

Choose Destination

See 1 citation found by title matching your search:

Dig Dis Sci. 2017 Mar;62(3):768-776. doi: 10.1007/s10620-016-4416-7. Epub 2016 Dec 26.

Gender-Specific Differences in Baseline, Peak, and Delta Serum Creatinine: The NACSELD Experience.

Author information

1
Division of Hepatology, Baylor Simmons Transplant Institute, Annette C. & Harold C. Simmons Transplant Institute, Baylor University Medical Center, 3410 Worth St, Suite 860, Dallas, TX, 75246, USA. dr_jackieo@yahoo.com.
2
Department of Medicine, University of Toronto, Toronto, ON, Canada.
3
Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA.
4
Department of Medicine, Yale University, New Haven, CT, USA.
5
Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
6
Department of Medicine, University of Colorado Denver, Denver, CO, USA.
7
Department of Medicine, University of Texas Health Science Center, Houston, TX, USA.
8
Department of Medicine, Emory University, Atlanta, GA, USA.
9
Department of Medicine, University of Rochester, Rochester, NY, USA.
10
Department of Medicine, Gastroenterology, Hepatology and Nutrition, Virginia Commonwealth University, Richmond, VA, USA.
11
McGuire VA Medical Center, Richmond, VA, USA.

Abstract

BACKGROUND:

Women have lower serum creatinine values than men for similar renal function.

AIMS:

We aimed to determine the differential effect of baseline, peak, and delta creatinine between genders on outcomes in infected hospitalized cirrhotic patients.

METHODS:

North American Consortium for the Study of End-Stage Liver Disease is a 15-center consortium of tertiary care hepatology centers prospectively enrolling infected cirrhotic inpatients. Baseline, peak, and delta creatinine during hospitalization were compared between genders, and their impact on overall survival, transplant-free survival, probability of transplantation, and need for renal replacement therapy (RRT) was analyzed.

RESULTS:

In total, 532 patients with cirrhosis (males = 59% median admission MELD = 20) had significantly lower median baseline (1.07 vs. 1.30 mg/dL, p < 0.0001) and peak creatinine (1.47 vs. 1.59 mg/dL, p = 0.024) in women than men during hospitalization for an infection, but both genders had similar delta creatinine levels (0.30 vs. 0.30 mg/dL, p = 0.957). Thirty-day mortality was similar between genders. RRT was not used more often in women (19 vs. 12%, p = 0.050), and women were 1.8 times more likely than men to receive RRT at the same creatinine (p = 0.028). Both peak and delta creatinine significantly predicted 6-month overall and transplant-free survival (p < 0.0001), but the probability of liver transplantation was affected by the interaction between gender and both peak and delta creatinine.

CONCLUSIONS:

Infected hospitalized cirrhotic women are significantly more likely than men to receive RRT at similar creatinine levels. Gender-specific differences in baseline, peak, and delta creatinine need further investigation to determine whether women need acute kidney injury treatment at lower creatinine thresholds than men.

KEYWORDS:

Acute kidney injury; Female; Gender; Liver transplant; Renal function

PMID:
28025746
DOI:
10.1007/s10620-016-4416-7
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Springer
Loading ...
Support Center