title: Should albumin be used in all patients with spontaneous bacterial peritonitis?
abstract: Patients with cirrhosis who develop spontaneous bacterial peritonitis (SBP) have been reported to experience a high incidence of renal impairment and mortality. Renal dysfunction is possibly related to altered systemic hemodynamics that leads to decreased effective arterial blood volume. Albumin, a plasma volume expander, has been investigated to determine whether it plays a role in patients with SBP. The current literature suggests that albumin can reduce renal impairment and mortality in high-risk SBP patients, defined as patients with a serum bilirubin level of greater than 68.4 μmol⁄L, a blood urea nitrogen level of greater than 10.7 mmol⁄L or a serum creatinine level greater than 88.4 μmol⁄L. The rationale for albumin and other volume expanders in SBP is discussed, accompanied by a review of the current literature.
authors.affiliation: Department of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Neeraj
authors.initials: N
authors.lastname: Narula
authors.forename: Keith
authors.initials: K
authors.lastname: Tsoi
authors.forename: John K
authors.initials: JK
authors.lastname: Marshall
mesh_terms: D000418:Albumins / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D001663:Bilirubin / Q000097:blood; D006801:Humans; D007674:Kidney Diseases / Q000209:etiology; D008103:Liver Cirrhosis / Q000150:complications / Q000188:drug therapy; D010538:Peritonitis / Q000150:complications / Q000188:drug therapy*; D010952:Plasma Substitutes / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D051437:Renal Insufficiency / Q000503:physiopathology
chemical_list: D000418:Albumins; D010952:Plasma Substitutes; D001663:Bilirubin