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Albumin to Reduce Mortality in Cirrhotic Patients with Acute Kidney Injury

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Reducing Mortality in Acute Kidney Injury

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Abstract

Acute kidney injury occurs in up to 20 % of cirrhotic patients hospitalized with portal hypertension and portosystemic collaterals. Reduction in the effective blood volume leads to pronounced vasoconstriction, involving preferentially renal and central nervous system blood vessels. Acute kidney injury is due to renal hypoperfusion and, accordingly, shows an improvement with volume expansion. The most well-established indications for albumin in cirrhosis are prevention of post-paracentesis circulatory dysfunction during large-volume paracentesis in the treatment of refractory ascites, prevention of hepatorenal syndrome in patients with spontaneous bacterial peritonitis, and hepatorenal syndrome treatment. A strong recommendation can be made for albumin administration in order to prevent acute kidney injury and to reduce mortality in cirrhotic patients with spontaneous bacterial peritonitis. Albumin may also have beneficial effects on a number of other complications in cirrhosis, although further studies are needed before any definitive conclusion can be made.

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Authors and Affiliations

  1. Department of Internal Medicine, Central Hospital of Bolzano, Lorenz Böhler Street 5, Bolzano, 39100, Italy

    Christian J. Wiedermann MD

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  1. Christian J. Wiedermann MD
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Correspondence to Christian J. Wiedermann MD .

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Editors and Affiliations

  1. Department of Anesthesia and Intensive Care, IRCCS San Raffaele Scientific Institute and Vita-Salute San Raffaele University, Milan, Italy

    Giovanni Landoni

  2. Cardiac Anesthesia & ICU, AORN Dei Colli, Monaldi Hospital Cardiac Anesthesia & ICU, Naples, Italy

    Antonio Pisano

  3. IRCCS San Raffaele Scientific Institute, Dept of Anesthesia & Intensive care, Milano, Milano, Italy

    Alberto Zangrillo

  4. Austin Hospital, Heidelberg, Victoria, Australia

    Rinaldo Bellomo

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Wiedermann, C.J. (2016). Albumin to Reduce Mortality in Cirrhotic Patients with Acute Kidney Injury. In: Landoni, G., Pisano, A., Zangrillo, A., Bellomo, R. (eds) Reducing Mortality in Acute Kidney Injury. Springer, Cham. https://doi.org/10.1007/978-3-319-33429-5_16

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  • DOI: https://doi.org/10.1007/978-3-319-33429-5_16

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-33427-1

  • Online ISBN: 978-3-319-33429-5

  • eBook Packages: MedicineMedicine (R0)

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