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Renal impairment increases mortality among patients with spontaneous bacterial peritonitis, despite administration of non-nephrotoxic antibiotics. Albumin infusion has been reported to reduce renal impairment and mortality in patients with spontaneous bacterial peritonitis . Dr Francesco Salerno and colleagues performed a meta-analysis of randomized controlled trials to quantify the effect of albumin infusion on renal impairment and mortality in patients with spontaneous bacterial peritonitis. The team searched MEDLINE, EMBASE, the Cochrane Library, and ClinicalTrials.gov for randomized controlled trials that evaluated albumin treatment for patients with spontaneous bacterial peritonitis. The team also performed searches by additional methods.  | | The pooled odds ratio for a reduction in renal impairment after albumin infusion was 0.2 | | Clinical Gastroenterology & Hepatology |
The research team included 4 trials of 288 total patients. Data were quantitatively combined under a fixed-effects model. The dotcors noted that they found no evidence of statistically significant heterogeneity or publication bias among the studies analyzed. Albumin was compared with no albumin in 3 trials and with artificial colloid in 1 trial. All patients received antibiotics. The researchers found that the incidence of renal impairment in control groups was 44 of 144, compared with 12 of 144 in groups given albumin. The pooled odds ratio for a reduction in renal impairment after albumin infusion was 0.2. Odds ratios for renal impairment after albumin therapy ranged from 0.19–0.30 among the individual studies. The doctors reported that thet mortality among controls was 51 of 144, compared with 23 of 144 among patients who received albumin. The pooled odds ratio for decreased mortality after infusion of albumin was 0.34. Dr Salerno's team concluded, "Odds ratios for mortality in individual randomized controlled trials ranged from 0.16–0.55."
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