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Literature Summary

Major Literature


1999 - Effect of IV Albumin on Renal Impairment and Mortality in Pts with Cirrhosis and SBP (NEJM)
  • Methods
    • 126 adult pts from 7 university hospitals with SBP without secondary peritonitis randomized to cefotaxime (63 pts) vs. cefotaxime + albumin (63 pts)
      • Albumin given as 1.5 g/kg on day 1 then 1 g/kg on day 3
  • Results
    • Primary outcomes
      • Incidence of renal impairment significantly lower in albumin group vs. no albumin group (10% vs. 33%)
        • Odds ratio of developing renal failure when receiving cefotax alone is 4.6!
      • In-hospital mortality was significantly lower in albumin group vs. no albumin group (10% vs. 29%)
      • 3 month mortality was significantly lower in albumin group vs. no albumin group (22% vs. 41%)
    • Secondary outcomes
      • Plasma renin activity was significantly lower in albumin group vs. no albumin group
      • No significant difference in MAP
  • Conclusion
    • In pts with cirrhosis and SBP, IV albumin + abx reduces incidence of renal impairment and death

 
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