Role of Albumin in Spontaneous Bacterial Peritonitis: Indications, Side-Effects and Outcome

Abstract

The most prevalent bacterial infection in cirrhotic patients is spontaneous bacterial peritonitis. Hospitalized patients with cirrhosis and ascites have an incidence that ranges between 10% and 30%, making it one of their primary complications. Since it may lead to kidney failure, hepatic encephalopathy, gastrointestinal bleeding, hypervolemic hyponatremia, the development of acute or chronic liver failure, systemic sepsis, so the outcomes in patients with spontaneous bacterial peritonitis are poor. Early antibiotic treatment is essential for bacterial spontaneous peritonitis. It is advised to utilize albumin in addition to antibiotics for some high-risk patients who have spontaneous bacterial peritonitis. The purpose of this research is to review the available information about the role of albumin in spontaneous bacterial peritonitis: indications, side-effects and outcome. Albumin is a plasma volume expander and is responsible for decreasing inflammatory response mediators such nitric oxide and the proinflammatory cytokines tumour necrosis factor-alpha and interleukin-6 because of this property it has a beneficial role in spontaneous bacterial peritonitis. Intravenous albumin administration has also been demonstrated to enhance systemic hemodynamic and renal function among spontaneous bacterial peritonitis patients. This effect is mediated by both an increase in cardiac function and a decrease in arterial vasodilatation Albumin along with the antibiotics is safe and effective in management of spontaneous bacterial peritonitis. It reduces the risk of renal complications and mortality. Although further research for standardizing the dosage and duration of albumin is needed.