Mini-dose albumin can reduce renal impairment in cirrhotic patients with spontaneous bacterial peritonitis

Elsaid, Abeer; Mokhtar, Abdel-Rahman; Seif, Seham; Ahmed, Nancy; El-Mashad, Noha; Anwar, Rokiah

doi:10.21608/mjvh.2020.125600

Mini-dose albumin can reduce renal impairment in cirrhotic patients with spontaneous bacterial peritonitis

Document Type : Original article

Authors

¹ Internal Medicine dept., (Hepatology & Gastroenterology), Mansoura Univ., Mansoura, Egypt.

² Internal Medicine dept., (Hepatology & Gastroenterology), Mansoura Univ., Mansoura, Egypt

³ Clinical Pathology, Specialized Medical Hospital, Mansoura Univ., Mansoura, Egypt.

10.21608/mjvh.2020.125600

Abstract

Background: Spontaneous bacterial peritonitis (SBP) is one of the most common and life threatening infections in cirrhosis. SBP patients are at high risk of developing renal impairment due to dete-rioration of systemic hemodynamics, intravenous albumin at a dose of 1.5 g/kg at diagnosis and 1 g/kg 48 h later has been shown to prevent renal impairment and reduce mortality in those patients. Such large dose of albumin is costly and not trouble free so it is important to assess other alternative regimens. The aim of the work is to assess using of mini-dose albumin 20% versus human plasma (as a source of isotonic albumin) in treatment of SBP and assess in hospital morbidity in term of occurrence of renal impairment and in hospital mortality. Patients and methods: This study included seventy five patients with decom-pensated cirrhosis and ascites complicated by SBP were divided into three groups each one included 25 patients as follow: Group (1) patients were administered mini-dose hypertonic albumin 20% (20g/ day) for 3-5 days plus antibiotic, group (2) patients were administered plasma (2 units/ day) for 3-5 days plus antibiotic, group (3) patients were administered antibiotic only. All groups were foll-owed for 5 days (duration of hospital admission) and compared as regards in hospital renal impair-ment (diagnosed by percentage of serum creatinine elevation) and in hospital mortality. Conclusion: mini-dose albumin (20g/d) plus antibiotics reduced significantly renal impairment in cirrhotic patients with SBP while plasma transfusion didn't.

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