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Low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis

OBJECTIVES: To evaluate the effect of low dose Albumin i.e. 4 grams per litre of ascitic fluid after large volume paracentesis (LVP) for the prevention of paracentesis induced circulatory dysfunction (PICD) related renal impairment in cirrhosis. METHODS: Case records of all patients with cirrhosis w...

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Autores principales: Hussain, Waqar, Khalid, Abdullah Bin, Usmani, Tayyab, Ghufran, Aiman, Shah, Hasnain
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Professional Medical Publications 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485277/
https://www.ncbi.nlm.nih.gov/pubmed/26150850
http://dx.doi.org/10.12669/pjms.313.7281
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author Hussain, Waqar
Khalid, Abdullah Bin
Usmani, Tayyab
Ghufran, Aiman
Shah, Hasnain
author_facet Hussain, Waqar
Khalid, Abdullah Bin
Usmani, Tayyab
Ghufran, Aiman
Shah, Hasnain
author_sort Hussain, Waqar
collection PubMed
description OBJECTIVES: To evaluate the effect of low dose Albumin i.e. 4 grams per litre of ascitic fluid after large volume paracentesis (LVP) for the prevention of paracentesis induced circulatory dysfunction (PICD) related renal impairment in cirrhosis. METHODS: Case records of all patients with cirrhosis who underwent LVP from January 12(th), 2011 till December 29(th), 2013 were reviewed. Patients were excluded if they had spontaneous bacterial peritonitis, creatinine >1.5 mg/dl, hepatoma or if volume of ascitic fluid removed was <5 litres. Data including age, gender, cause of cirrhosis, CTP score and volume of ascitic fluid drained were noted. In addition serum creatinine and serum sodium at baseline and one week post paracentesis were recorded. RESULTS: Two hundred and fourteen patients with cirrhosis underwent LVP during the study period. One hundred and thirty nine patients met the inclusion criteria and were analyzed. Patients were divided into two groups based on the amount of albumin given. The amount of albumin given was 25 grams and 50 grams while the volume of ascitic fluid removed were 6.2±1 litres and 10.4±1.5 litres in groups A and B respectively. One hundred and eight patients were in group A while thirty one patients were in group B respectively. Both groups received albumin at a dose of 4 grams per litre of ascitic fluid removed. Mean age in both groups were 53 years. Hepatitis C was the commonest etiology in both the groups, followed by Hepatitis B. More than 70% patients in both the groups were in child class C. Serum creatinine at baseline and one week post LVP was 1.04±0.24 mg/dl and 1.07±0.35 mg/dl in GROUP A while 1.11±0.23 mg/dl and 1.41±0.94 mg/dl in GROUP B. (P value 0.35). Similarly, serum sodium at baseline and one week post LVP was 130 ±5.6 meq/lit and 129.6±5.9 meq/lit in GROUP A while 127.6±5.8 meq/lit and 128±6.2 meq/lit in GROUP B respectively. (P value 0.14) CONCLUSION: This study suggests that 4 grams of albumin per litre of ascitic fluid drained is effective in preventing the PICD related renal impairment following large volume paracentesis in cirrhosis
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spelling pubmed-44852772015-07-06 Low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis Hussain, Waqar Khalid, Abdullah Bin Usmani, Tayyab Ghufran, Aiman Shah, Hasnain Pak J Med Sci Original Article OBJECTIVES: To evaluate the effect of low dose Albumin i.e. 4 grams per litre of ascitic fluid after large volume paracentesis (LVP) for the prevention of paracentesis induced circulatory dysfunction (PICD) related renal impairment in cirrhosis. METHODS: Case records of all patients with cirrhosis who underwent LVP from January 12(th), 2011 till December 29(th), 2013 were reviewed. Patients were excluded if they had spontaneous bacterial peritonitis, creatinine >1.5 mg/dl, hepatoma or if volume of ascitic fluid removed was <5 litres. Data including age, gender, cause of cirrhosis, CTP score and volume of ascitic fluid drained were noted. In addition serum creatinine and serum sodium at baseline and one week post paracentesis were recorded. RESULTS: Two hundred and fourteen patients with cirrhosis underwent LVP during the study period. One hundred and thirty nine patients met the inclusion criteria and were analyzed. Patients were divided into two groups based on the amount of albumin given. The amount of albumin given was 25 grams and 50 grams while the volume of ascitic fluid removed were 6.2±1 litres and 10.4±1.5 litres in groups A and B respectively. One hundred and eight patients were in group A while thirty one patients were in group B respectively. Both groups received albumin at a dose of 4 grams per litre of ascitic fluid removed. Mean age in both groups were 53 years. Hepatitis C was the commonest etiology in both the groups, followed by Hepatitis B. More than 70% patients in both the groups were in child class C. Serum creatinine at baseline and one week post LVP was 1.04±0.24 mg/dl and 1.07±0.35 mg/dl in GROUP A while 1.11±0.23 mg/dl and 1.41±0.94 mg/dl in GROUP B. (P value 0.35). Similarly, serum sodium at baseline and one week post LVP was 130 ±5.6 meq/lit and 129.6±5.9 meq/lit in GROUP A while 127.6±5.8 meq/lit and 128±6.2 meq/lit in GROUP B respectively. (P value 0.14) CONCLUSION: This study suggests that 4 grams of albumin per litre of ascitic fluid drained is effective in preventing the PICD related renal impairment following large volume paracentesis in cirrhosis Professional Medical Publications 2015 /pmc/articles/PMC4485277/ /pubmed/26150850 http://dx.doi.org/10.12669/pjms.313.7281 Text en Copyright: © Pakistan Journal of Medical Sciences http://creativecommons.org/licenses/by/3.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hussain, Waqar
Khalid, Abdullah Bin
Usmani, Tayyab
Ghufran, Aiman
Shah, Hasnain
Low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis
title Low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis
title_full Low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis
title_fullStr Low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis
title_full_unstemmed Low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis
title_short Low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis
title_sort low dose albumin for the prevention of renal impairment following large volume paracentesis in cirrhosis
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4485277/
https://www.ncbi.nlm.nih.gov/pubmed/26150850
http://dx.doi.org/10.12669/pjms.313.7281
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