Effect of Albumin in Cirrhotic Patients with Infection Other Than Spontaneous Bacterial Peritonitis. A Randomized Trial.
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Date publication
novembre 2014
Auteurs
Membres identifiés du Cancéropôle Est :
Pr DI MARTINO Vincent, Dr MINELLO Anne
Tous les auteurs :
Thevenot T, Bureau C, Oberti F, Anty R, Louvet A, Plessier A, Rudler M, Heurgue-Berlot A, Rosa I, Talbodec N, Dao T, Ozenne V, Carbonell N, Causse X, Goria O, Minello A, De Ledinghen V, Amathieu R, Barraud H, Nguyen-Khac E, Becker C, Paupard T, Botta-Fridlung D, Abdelli N, Guillemot F, Monnet E, Di Martino V
Lien Pubmed
Résumé
BACKGROUND&AIMS: Albumin infusion improves renal function and survival in cirrhotic patients with spontaneous bacterial peritonitis (SBP) but its efficacy in other types of infections remains unknown. We investigated this issue through a multicenter randomized controlled trial. METHODS: A total of 193 cirrhotic patients with a Child-Pugh score greater than 8 and sepsis unrelated to SBP were randomly assigned to receive antibiotics plus albumin (1.5 g/kg on day 1 and 1 g/kg on day 3; albumin group [ALB]:n=96) or antibiotics alone (control group [CG]:n=97). The primary endpoint was the 3-month renal failure rate (increase in creatinine 50% to reach a final value 133mumol/L). The secondary endpoint was 3-month survival rate. RESULTS: Forty-seven (24.6%) patients died (ALB: n=27 vs CG: n=20; 3-month survival: 70.2% vs. 78.3%; p=0.16). Albumin infusion delayed the occurrence of renal failure (mean time to onset, ALB: 29.0+/-21.8 vs 11.7+/-9.1 days, p=0.018) but the 3-month renal failure rate was similar (ALB: 14.3% vs CG: 13.5%; p=0.88). By multivariate analysis, MELD score (p
Référence
J Hepatol. 2014 Nov 21. pii: S0168-8278(14)00862-9