A team from Shanghai, China, determined whether plasma volume expansion with albumin could prevent impairment of renal function and reduce mortality in cirrhotic patients with either acute spontaneous bacterial peritonitis (SBP), or patients complicated with SBP.
A total of 112 patients were randomly allocated to two groups. Some 56 patients were treated with ceftriaxone alone (Group 1) and the other 56 patients were treated with ceftriaxone plus intravenous albumin (Group 2) for 3 weeks.
Serum creatinine and blood urea nitrogen levels were monitored.
The researchers found that 19 and 5 patients had renal impairment, in Groups 1 and 2, respectively.
The incidence of renal impairment was significantly lower in patients treated with ceftriaxone and albumin (10%) than in patients treated with ceftriaxone alone (34%).
|Incidence of renal impairment:|
Ceftriaxone alone: 34%
Ceftriaxone plus albumin: 10%
| Chinese Journal of Digestive Diseases |
In addition, in-hospital mortality in Group 2 was 10% (5/56), but was 33% (17/56) in Group 1.
Thus, in-hospital mortality was significantly reduced in patients treated with ceftriaxone and albumin.
Hui Ping Xue, of the Shanghai Renji Hospital, concluded on behalf of colleagues, "The addition of intravenous albumin to an antibiotic regimen reduces the incidence of renal impairment and mortality in cirrhotic patients with SBP."