The role of albumin replacement therapy in the treatment of hepatic encephalopathy in patients with liver cirrhosis

Abstract

Introduction. It is often observed that decompensated liver cirrhosis is accompanied by hepatic encephalopathy. The role of violation of the structural and functional properties of albumin in the development of this pathology is currently not defined.Aim. Was to evaluate the effect of albumin replacement therapy on the clinical manifestations of hepatic encephalopathy and the severity of structural and functional changes in serum albumin.Materials and methods. The study included 28 adult patients with decompensated cirrhosis and hepatic encephalopathy divided into two comparable groups. In addition to the standard examination, the properties of the albumin molecule were evaluated using the EPR test. The dynamics of indicators was assessed in the groups of standard treatment and standard treatment + albumin. Mathematical processing was carried out in the StatTech v. 3.1.4 (developer Stattech LLC, Russia).Results and discussion. It was revealed that patients with decompensated liver cirrhosis have serious disturbances in the albumin configuration, which lead to a decrease in its functional activity. The ability to bind, transport and detoxify were impaired in the vast majority of patients. The native conformation of the molecule was abnormal in all patients. Against the background of albumin replacement therapy, these disorders are able to recover to normal values. Along with this, we found that albumin replacement therapy reduced the severity of hepatic encephalopathy to a greater extent than standard treatment.Conclusion. Violation of the structural and functional albumin properties is associated with the progression of hepatic encephalopathy in patients with liver cirrhosis. Transfusions of highly concentrated human albumin lead to the normalization of the molecule properties and the encephalopathy regression.