Abstract
Albumin infusion improves renal function in cirrhosis; however, mechanisms are incompletely understood. In clinical practice, human albumin is used in various intensive care unit indications to deal with a wide range of problems, from volume replacement in hypovolemic shock, or sepsis, to treatment of ascites in patients with liver cirrhosis. Against the background of the results of recent studies on the use of human albumin in septic patients, the importance of the natural colloid in these critically ill patients is being redefined. In addition to the hemodynamic effects of administration of human albumin impacting on sympathetic tone, attention is being paid to other effects in which its pharmacodynamics is associated with the physiological importance of endogenous albumin. The morbidity and mortality data discussed in this paper support the importance of both the hemodynamic and the pharmacological effects of the administration of human albumin in various indications. The contribution that human albumin could make towards the maintenance of renal function in the course and treatment of severe sepsis and cirrhosis of the liver is the subject of this narrative review.
Highlights
Criteria for ideal volume substitute, its safety aspect, are increasingly becoming the subject of discussion
The contribution that human albumin could make towards the maintenance of renal function in the course and treatment of severe sepsis and cirrhosis of the liver is the subject of this narrative review
Hypoalbuminemia is associated with increased risk for the development of acute kidney injury (AKI) and a fatal outcome of AKI
Summary
Criteria for ideal volume substitute, its safety aspect, are increasingly becoming the subject of discussion. The update on guidelines reflects this development: The International Surviving Sepsis Campaign [1] recommends that, for initial volume substitution in severe sepsis and septic shock, crystalloid preparations should be used first and not HES Evidence bases for this recommendation are the studies VISEP, CRYSTMAS, 6S, and CHEST [2,3,4,5], which showed a trend in the HES groups [2, 3, 5] or significance [4] for higher mortality and the need to employ renal replacement therapy significantly more frequently. This review discusses the potential benefits of albumin infusion for renal function in patients with cirrhosis of the liver
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
