Human albumin infusion is safe and effective even in patients without acute kidney injury and spontaneous bacterial peritonitis

• Published in: Indian journal of gastroenterology 2024-04, Vol.43 (2), p.485-493
• Main Authors: Kulkarni, Anand V., Zuberi, Asim Ahmed, Chaitanya, K., Doolam, Harshitha, Reddy, Santhosh, Lakshmi, P. K., Godbole, Shubankar, Shantan, Venishetty, Iyengar, Sowmya, Alla, Manasa, Sharma, Mithun, Reddy, D. Nageshwar, Rao, P. N.
• Format: Article
• Language: English
• Subjects: Acute Kidney Injury - etiology; Acute-On-Chronic Liver Failure - complications; Acute-On-Chronic Liver Failure - etiology; Acute-On-Chronic Liver Failure - mortality; Adult; Aged; Albumins - administration & dosage; Bacterial Infections - drug therapy; Bacterial Infections - etiology; Female; Gastroenterology; Hepatology; Hospitalization; Humans; Hyponatremia - etiology; Infusions, Intravenous; Liver Cirrhosis - complications; Male; Medicine; Medicine & Public Health; Middle Aged; Original Article; Peritonitis - drug therapy; Peritonitis - etiology; Prospective Studies; Treatment Outcome
• ISSN: 0254-8860; 0975-0711
• DOI: 10.1007/s12664-023-01475-0

Background and Objectives Human albumin (HA) solution is currently recommended only for patients with spontaneous bacterial peritonitis (SBP) and acute kidney injury (AKI). However, its use in hospitalized patients is quite frequent. The objective was to compare the outcomes of patients receiving HA in recommended (Gr. A) vs. non-recommended (Gr. B) indications. Methods In this prospective study, consecutive hospitalized patients who received HA were included. Apart from comparing the proportion of patients achieving resolution of hyponatremia, infection and hepatic encephalopathy among Gr. A and Gr. B, we also compared the in-hospital survival and performed a sub-group analysis of patients with the European Association for the Study of the Liver (EASL) acute-on-chronic liver failure (ACLF) and decompensated cirrhosis (DC). Results Of the 396 hospitalized patients who received HA, 180 had AKI and/or SBP (Gr. A), and 216 received albumin for non-recommended indications (Gr. B). The mean age, sex and etiology distribution were similar. The total dose of HA was higher (88 ± 61.62 g vs. 71.31 ± 488.17 g; p  = 0.003) and the duration longer (4 ± 2.37 vs. 3.4 ± 1.82 days; p  = 0.005) in Gr. A than B. The resolution of infection and HE was similar among both groups, while hyponatremia resolution was significantly higher in Gr. B (94.7%) than Gr. A (75.6%; p