The efficacy and safety profile of albumin administration for patients with cirrhosis at high risk of hepatorenal syndrome is dose dependent

作     者：Yuliya Afinogenova Elliot B.Tapper 

作者机构：Harvard Medical SchoolBostonMAUSA Division of Gastroenterology and HepatologyBeth Israel Deaconess Medical CenterHarvard Medical SchoolBostonMAUSA 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2015年第3卷第3期

页      面：216-221页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

基　　金：supported by a grant from the Scholars in Medicine office Harvard Medical School.Dr.Tapper was supported by a grant from the Carl J.Shapiro Institute for Education and Research.The content is solely the responsibility of the authors and does not necessarily represent their funding institutions 

主　　题：albumin cirrhosis ascites hepatorenal syndrome acute renal failure spontaneous bacterial peritonitis 

摘      要：Background:Albumin is a critical component in the standard therapeutic approach to acute renal failure(ARF)and spontaneous bacterial peritonitis(SBP)in the setting of ***,data regarding the safety and minimumeffective dose are ***:We conducted a retrospective review of patients with decompensated cirrhosis who received albumin within the first 48 hours of hospitalization at Beth Israel Deaconess Medical Center between 2010 and *** included 90-day risk of death or transplantation(primary)and(secondary)complications of albumin infusion(length of stay(LOS)and need for critical care),all adjusted for comorbidity and severity of ***:We included 169 patients with ARF and 88 patients with *** optimal doses of albumin for a survival benefit were found to be 87.5 g and 100 g in the ARF and SBP cohorts,*** odds ratio(OR)for the 90-day risk of death or liver transplantation associated with the optimal loading dose was 0.36(95%CI:0.17-0.76,P=0.008)and 0.28(95%CI:0.07-0.97,P=0.04)for the ARF and SBP cohorts,*** effect persisted for patients with ARF who had neither hepatorenal syndrome(HRS)nor SBP(OR:0.13,95%CI:0.007-0.79,P=0.02).LOS(beta coefficient per log albumin dose:1.69;95%CI:0.14-3.24,P=0.03)and risk of critical care(OR/g albumin:1.03;95%CI:1.01-1.05,P=0.01)were also dose ***:Albumin has a dose-dependent effect on both survival and complications in patients with cirrhosis with ARF(HRS and otherwise)and/or SBP.