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Albumin for cirrhotic patients with extraperitoneal infections: A meta-analysis

Gabriel Stefani Leão1, Guilherme John Neto2,3, Raquel de Freitas Jotz2,3

  • 1Graduate Program in Medicine: Hepatology, Federal University of Health Sciences of Porto Alegre, Porto Alegre, Brazil.

Journal of Gastroenterology and Hepatology
|July 30, 2019
PubMed
Abstract

Insights

Albumin combined with antibiotics does not improve survival or kidney function in cirrhotic patients with extraperitoneal infections. This meta-analysis found no significant benefits for albumin in treating these specific bacterial infections.

Area of Science:

  • Hepatology and Infectious Diseases
  • Clinical Pharmacology
  • Evidence-Based Medicine

Background:

  • Bacterial infections are a leading cause of mortality in cirrhosis patients.
  • Albumin's benefit is established for spontaneous bacterial peritonitis but debated for extraperitoneal infections.

Purpose of the Study:

  • To compare the efficacy of albumin plus antibiotics versus antibiotics alone in cirrhotic patients with extraperitoneal infections.
  • To evaluate the impact on mortality and renal dysfunction.

Main Methods:

  • Systematic review of randomized controlled trials from MEDLINE and Embase.
  • Meta-analysis using a random effects model (Mantel-Haenszel method).
  • Inclusion criteria: cirrhotic patients with extraperitoneal infections, comparing albumin + antibiotics vs. antibiotics alone, assessing mortality or renal dysfunction.

Main Results:

  • Three randomized controlled trials were included.
  • No significant difference in 30-day or 90-day mortality between groups.
  • No significant difference in renal dysfunction between groups.

Conclusions:

  • Current evidence does not support the use of albumin for cirrhotic patients with extraperitoneal infections.
  • Albumin offers no significant benefit regarding mortality or renal dysfunction in this patient population.
Keywords:
AlbuminCirrhosisExtraperitonealInfectionMeta-analysis

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