Background & Aims: Renal impairment increases mortality among patients with spontaneous bacterial peritonitis (SBP), despite administration of non-nephrotoxic antibiotics. Albumin infusion has been reported to reduce renal impairment and mortality in patients with SBP. We performed a meta-analysis of randomized controlled trials (RCTs) to quantify the effect of albumin infusion on renal impairment and mortality in patients with SBP. Methods: We searched MEDLINE, EMBASE, the Cochrane Library, and ClinicalTrials.gov for RCTs that evaluated albumin treatment for patients with SBP; we also performed searches by additional methods. Four trials of 288 total patients were included in our analysis. Data were quantitatively combined under a fixed-effects model.Results: We found no evidence of statistically significant heterogeneity or publication bias among the studies analyzed. Albumin was compared with no albumin in 3 trials and with artificial colloid in 1 trial. All patients received antibiotics. The incidence of renal impairment in control groups was 44 of 144 (30.6%), compared with 12 of 144 (8.3%) in groups given albumin. The pooled odds ratio for a reduction in renal impairment after albumin infusion was 0.21 (95% confidence interval, 0.11-0.42). Odds ratios for renal impairment after albumin therapy ranged from 0.19-0.30 among the individual studies. Mortality among controls was 51 of 144 (35.4%), compared with 23 of 144 (16.0%) among patients who received albumin. The pooled odds ratio for decreased mortality after infusion of albumin was 0.34 (95% confidence interval, 0.19-0.60). Odds ratios for mortality in individual RCTs ranged from 0.16-0.55.Conclusions: In a meta-analysis of 4 RCTs (288 patients), albumin infusion prevented renal impairment and reduced mortality among patients with SBP.
Albumin Infusion Improves Outcomes of Patients with Spontaneous Bacterial Peritonitis: A Meta-analysis of Randomized Trials / F. Salerno, R.J. Navickis, M.M. Wilkes. - In: CLINICAL GASTROENTEROLOGY AND HEPATOLOGY. - ISSN 1542-3565. - 11:2(2013), pp. 123-130e1.
|Titolo:||Albumin Infusion Improves Outcomes of Patients with Spontaneous Bacterial Peritonitis: A Meta-analysis of Randomized Trials|
SALERNO, FRANCESCO (Corresponding)
|Parole Chiave:||Ascites; Cirrhosis; Infection; Kidney Failure; Adult; Aged; Albumins; Bacterial Infections; Female; Humans; Male; Middle Aged; Peritonitis; Randomized Controlled Trials as Topic; Renal Insufficiency; Survival Analysis; Treatment Outcome; Young Adult; Gastroenterology; Hepatology|
|Settore Scientifico Disciplinare:||Settore MED/09 - Medicina Interna|
Settore MED/12 - Gastroenterologia
|Data di pubblicazione:||2013|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1016/j.cgh.2012.11.007|
|Appare nelle tipologie:||01 - Articolo su periodico|