Contribution of diuretic therapy with human serum albumin to the management of ascites in patients with advanced liver cirrhosis: A prospective cohort study.
The number of available studies on the role of human serum albumin (HSA) in the treatment of cirrhotic ascites is currently limited. In this study, we aimed to investigated the parameters associated with diuretic therapy with HSA in patients with advanced cirrhotic ascites. The patient inclusion criteria were cirrhotic ascites and a serum albumin (Alb) concentration of <3.5 g/dl. A total of 49 patients registered and 38 patients were ultimately included in this study. The enrolled patients were mainly treated with oral spironolactone and furosemide, which were not specified; the HSA amount was also not specified, although the administration period was set to a maximum of 7 days. Our results demonstrated that the administration of HSA significantly increased the serum levels of Alb [0.97 g/dl; two-sided 95% confidence interval (CI): 0.83-1.11 g/dl] and decreased body weight (-2.24 kg; 95% CI: -3.06 to -1.43 kg), hematocrit ratio (0.96; 95% CI: 0.94-0.98) and plasma renin concentration (day 4; geometric mean fold change, -0.1528; 95% CI: -0.2510 to -0.0545; log-transformed data) in patients with advanced cirrhotic ascites. The observed weight loss was found to be correlated with the total amount of HSA administered (P=0.0012), as indicated by the results of the multiple linear regression analysis. In conclusion, this study confirmed the efficacy of HSA in patients with advanced cirrhotic ascites.
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011; ; Liver Cancer Division, Research Center for Innovative Cancer Therapy, Kurume University, Kurume, Fukuoka 830-0011;
Toru
T
Nakamura
Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Fukuoka 830-0011;
Michio
M
Sata
Division of Gastroenterology and Hepatology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666;
Kazumasa
K
Hiroishi
Department of Gastroenterology, National Center for Global Health and Medicine, Shinjuku-ku, Tokyo 162-8655;
Naohiko
N
Masaki
Department of Gastroenterology, Gifu University School of Medicine, Gifu 501-1194;
Hisataka
H
Moriwaki
Second Department of Internal Medicine, Faculty of Medicine,Tottori University, Yonago, Tottori 683-8504;
Yoshikazu
Y
Murawaki
Clinical Research Center, National Hospital Organization, Nagasaki Medical Center, Omura, Nagasaki 856-8562;
Hiroshi
H
Yatsuhashi
Department of Gastroenterology and Hepatology, NTT West Kyushu Hospital, Chuo-ku, Kumamoto 862-8655, Japan.
Shigetoshi
S
Fujiyama
Division of Gastroenterology and Hepatology, Department of Medicine, Showa University School of Medicine, Shinagawa-ku, Tokyo 142-8666;
Michio
M
Imawari
ascites; diuretics; human serum albumin; liver cirrhosis