ArticleCanadian liver journal2025
A retrospective study on the use of albumin in the management of complications of decompensated cirrhosis from a major teaching hospital in Canada.
Article in Canadian liver journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Various academic societies have recommended the use of albumin for managing ascites and its complications. This study aims to assess adherence to recommended albumin dosing and scheduling for large volume paracentesis (LVP), acute kidney injury (AKI), spontaneous bacterial peritonitis (SBP), and infections other than SBP. Clinical outcomes were correlated with albumin use. Methods: Patient demographics, past cirrhosis complications, details of albumin use, further complications and readmissions after the index event, and 6-month survival were collected. Results: 220 patients were included from March 2020 to March 2021 (68% men, mean age 61.3 [SD 12.1] y). LVP patients (n = 58) received a higher than recommended dose of albumin of 12 (SD 12) g/L of ascites drained and had the least complications at presentation or readmissions during follow-up, with a 6-month survival of 79%. SBP patients (n = 32) had a mean daily albumin dose of 48 (SD 18) g for a mean of 3.5 (SD 2.1) days, with the most complications during the index event, and more patients needing readmissions during follow-up, with the lowest survival of 28% at 6 months. All AKI patients (n = 62) received approximately 50 g/day of albumin irrespective of AKI stage. Renal recovery was inversely correlated with AKI stage. Six-month survival was 48%. The use of albumin for other infections (n = 68) was mostly for bacteremia, with a 67.7% 6-month survival. Conclusions: The use of albumin in decompensated cirrhosis does not seem to follow the recommendations as set by treatment guidelines. Formal albumin dose-response studies may help to identify the most appropriate doses of albumin for the approved indications in decompensated cirrhosis.
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