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Albumin for bacterial infections other than spontaneous bacterial peritonitis in cirrhosis. A randomized, controlled study.


J Hepatol. 2012 Jun 22;


Authors: Guevara M, Terra C, Nazar A, Solà E, Fernández J, Pavesi M, Arroyo V, Ginès P


Abstract

BACKGROUND AND AIM: 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). Primary end-point was survival at 3 months. Secondary end-points were effects on renal and circulatory function. RESULTS: 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. 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=ns). 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. CONCLUSION: as compared with standard antibiotic therapy alone, treatment with albumin together with antibiotics has beneficial effects on renal and circulatory function and shows a potential survival benefit. Further studies with large sample sizes should be performed to confirm these findings (Clinicaltrials.gov NCT 00124228).

PMID: 22732511 [PubMed - as supplied by publisher]