In cirrhotics, is albumin necessary not only with paracentesis, but also in SBP as HRS prophylaxis?

Albumin infusion in patients undergoing large volume paracentesis: A meta-analysis of randomized trials.

Background: IV albumin has been used as a plasma volume expander. In cirrhotics albumin keeps an essential role in solubilization, transport and metabolism of a variety of molecules. It also has some immonumodulatory properties.

Design: A recent review focused on the role of albumin in cirrhotics.

Results: Well established indications were concluded from this review for the use of albumin.

-Spontaneous bacterial peritonitis: albumin + antibiotics reduces the incidence of renal failure and improves survival.

-Hepatorenal syndrome: albumin + vasoconstrictors decrease mortality.

-Paracentesis-induced circulatory dysfunction. Albumin helps prevent this syndrome.

A lot of other biologic functions of albumin were outlined in this review which leads to other indications of its use.