Serum creatinine in cirrhotic patients: a cornerstone

In arecent issue of Hepatology, Cullaro et al. highlighted, in apopulation of cirrhotic patients listed for liver transplant, the associationbetween patient’ s basal serum creatinine level, including “normal rangevalues” and the occurrence of acute kidney injury (AKI), the persistent kidneyinjury after AKI, and the death/delisting risk (1). In this retrospective singlecenter study involving 385 patients, they showed thanks to a competing riskanalysis, that each 1mg/dL increase of basal serum creatinine was associatedwith a 62 % higher risk of mortality. If these results confirm the crucialprognosis impact of an impaired renal function in cirrhotic patients, they alsoencourage us to stay alert to changes in creatinine values within the normalrange. This paper leads to key reflections on creatinine role in cirrhosismanagement.