Albumin in Spontaneous Bacterial Peritonitis

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July 4, 2017 by Casey Carr

By: Binoy Mistry


Mortality in spontaneous bacterial peritonitis ranges from 20-40%; renal impairment can occur up to 40% of cases. Albumin infusions are thought to bind endotoxins and nitric oxide, as well as help to increase intravascular volume, leading to decreased renal impairment and mortality.


2013 systemic review (Salerno et al) found that in patient’s diagnosed with SBP (>250/mm3 WBC in ascitic fluid) albumin infusion within 6 hours decreased rates of renal impairment (30.6% vs 8.3%) and mortality (35.4% vs 16%). NNT to prevent one death = 6, NNT to prevent one case of renal failure = 4.


0.5-1.5 g/kg of 20% solution within 6 hours.


Salerno F, Navickis RJ, Wilkes MM. Albumin infusion improves outcomes of patients with spontaneous bacterial peritonitis: a meta-analysis of randomized trials. Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association. 11(2):123-30.e1. 2013.

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