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

Autor:	O'Leary, Jacqueline, Wong, Florence, Reddy, K., Garcia-Tsao, Guadalupe, Kamath, Patrick, Biggins, Scott, Fallon, Michael, Subramanian, Ram, Maliakkal, B., Thacker, Leroy, Bajaj, Jasmohan, O'Leary, Jacqueline G, Reddy, K Rajender, Kamath, Patrick S, Biggins, Scott W, Fallon, Michael B, Subramanian, Ram M, Bajaj, Jasmohan S
Předmět:	CREATININE CIRRHOSIS of the liver LIVER transplantation CHRONIC kidney failure TERTIARY care PATIENTS INFECTION treatment KIDNEY disease statistics ACUTE kidney failure COMPARATIVE studies HOSPITAL care INFECTION KIDNEY function tests KIDNEY diseases LIVER failure LONGITUDINAL method RESEARCH methodology MEDICAL cooperation RESEARCH RISK assessment SEX distribution SURVIVAL analysis (Biometry) THERAPEUTICS EVALUATION research SEVERITY of illness index PATIENT selection DISEASE complications
Zdroj:	Digestive Diseases & Sciences; Mar2017, Vol. 62 Issue 3, p768-776, 9p
Abstrakt:	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. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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