SHM Converge Scientific Abstract ePoster Gallery-Association of Paracentesis Volume Removal and Creatinine Change

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This retrospective single-center study from Parkland Health examined whether the amount of ascitic fluid removed during paracentesis affected kidney function in patients with decompensated cirrhosis and renal impairment. The cohort included 102 patients (mean age 57 years, 63% male) with a mean baseline creatinine of 2.0 mg/dL and mean MELD score of 12.8. The average paracentesis volume removed was 5.4 liters.<br /><br />The main finding was that larger paracentesis volumes were associated with improved renal function at 48 hours. In a fully adjusted mixed-effects linear regression model, each additional liter removed was linked to a 0.04 mg/dL decrease in serum creatinine at 48 hours. This association remained significant after adjusting for relevant clinical factors. Post-procedural albumin administration was not independently associated with creatinine improvement.<br /><br />Patients who had more than 5 liters removed differed somewhat from those with 5 liters or less, but overall baseline characteristics were similar between groups. The study excluded patients with ESRD, suspected hepatorenal syndrome, multiple paracenteses during admission, or missing 48-hour creatinine values.<br /><br />The authors conclude that conservative fluid removal during paracentesis may be unnecessary in patients with cirrhosis and renal impairment, since larger-volume removal was associated with better short-term creatinine outcomes. However, because the study was retrospective and single-center, confounding and limited generalizability remain concerns. The authors recommend randomized trials to better determine the relationship between paracentesis volume and renal function.

Asset Subtitle

Justin Brewer

Meta Tag

Author List Andrea Kwan, Andrew Sumarsono, Anneshia Redic, Dergham Alzubaidy, Erin James, Jiten Patel, Justin Brewer, Lorraine Rosales, Sarah Daemi, Sayda Major, Vivek Patel

Category Research

Concept Paracentesis

Concept Creatinine

Concept Cirrhotic Ascites

Concept Renal Disease

Concept Paracentesis Volume

Distinguished Non-Finalist

Presenter Organization Parkland Health

Presenting Author Justin Brewer

Track Outcomes Research

Keywords

paracentesis

ascitic fluid

decompensated cirrhosis

renal impairment

creatinine

kidney function

albumin administration

retrospective study

MELD score

large-volume paracentesis

Paracentesis

Creatinine

Cirrhotic Ascites

Renal Disease

Paracentesis Volume