Background & Aims
Treatment with albumin in patients with cirrhosis and spontaneous bacterial peritonitis
(SBP) prevents renal failure and improves survival. Whether albumin has similar beneficial
effects in patients with infections other than SBP is unknown.
Methods
One hundred and ten patients with cirrhosis hospitalized for infections other than
SBP were randomly assigned to receive antibiotics plus albumin (1.5 g/kg bw at diagnosis and 1 g/kg bw at day 3) (albumin group; n = 56) or antibiotics alone (control group; n = 54). The primary end point was survival at 3 months. Secondary end points were effects on renal and circulatory function.
Results
The renal function, as evaluated by differences in changes in serum creatinine and
estimated glomerular filtration rate between the two groups, improved in patients
treated with albumin. The circulatory function improved significantly in patients
treated with albumin, but not in those from the control group. There was a trend for
a lower frequency of type 1 hepatorenal syndrome in the albumin group compared to
the control group (1 vs. 4 patients, respectively; p = n.s.). Probability of survival at 3 months was not significantly different among the two groups. However, when adjusted
for factors with independent prognostic value, treatment with albumin was an independent
predictive factor of survival.
Conclusions
As compared with standard antibiotic therapy alone, treatment with albumin together
with antibiotics has beneficial effects on the renal and circulatory function and
shows a potential survival benefit. Further studies with large sample sizes should
be performed to confirm these findings.
Abbreviations:
SBP (spontaneous bacterial peritonitis), PMN (polymorphonuclear), HIV (human immunodeficiency virus), HRS (hepatorenal syndrome), eGFR (estimated glomerular filtration rate), BUN (blood urea nitrogen)Keywords
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Article info
Publication history
Published online: June 25, 2012
Accepted:
June 6,
2012
Received in revised form:
June 4,
2012
Received:
December 16,
2011
Footnotes
☆Clinicaltrials.gov NCT 00124228.
Identification
Copyright
© 2012 European Association for the Study of the Liver. Published by Elsevier Inc. All rights reserved.
