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. 2022 Dec 23;12(1):107.
doi: 10.3390/jcm12010107.

Effects of Short-Term Human Albumin Infusion for the Prevention and Treatment of Hyponatremia in Patients with Liver Cirrhosis

Zhaohui Bai  1   2 , Wentao Xu  1   2 , Lu Chai  1   2 , Xiaojie Zheng  1 , Nahum Méndez-Sánchez  3 , Cyriac Abby Philips  4 , Gang Cheng  2 , Xingshun Qi  1   2
Affiliations

Effects of Short-Term Human Albumin Infusion for the Prevention and Treatment of Hyponatremia in Patients with Liver Cirrhosis

Zhaohui Bai et al. J Clin Med. .

Abstract

Background: Human albumin (HA) infusion is potentially effective for the management of hyponatremia in liver cirrhosis, but the current evidence is very limited. Methods: In this retrospective study, 2414 cirrhotic patients who were consecutively admitted to our hospital between January 2010 and June 2014 were included in the Hospitalization outcome cohort, and 339 cirrhotic patients without malignancy who were consecutively admitted to our department between December 2014 and April 2021 were included in the Long-term outcome cohort. The development and improvement of hyponatremia were compared between patients who received HA infusion during hospitalizations and did not. Logistic and Cox regression analyses were performed to evaluate the association of development and improvement of hyponatremia during hospitalizations with the outcomes. Odds ratios (ORs) and hazard ratios (HRs) were calculated. Results: In the two cohorts, HA infusion significantly decreased the incidence of hyponatremia and increased the rate of improvement of hyponatremia in cirrhotic patients during hospitalizations. In the Hospitalization outcome cohort, the development of hyponatremia during hospitalizations was significantly associated with increased in-hospital mortality (OR = 2.493, p < 0.001), and the improvement of hyponatremia during hospitalizations was significantly associated with decreased in-hospital mortality (OR = 0.599, p = 0.014). In the Long-term outcome cohort, the development of hyponatremia during hospitalizations was significantly associated with decreased long-term survival (HR = 0.400, p < 0.001), and the improvement of hyponatremia during hospitalizations was not significantly associated with long-term survival (HR = 1.085, p = 0.813). Conclusions: HA infusion can effectively prevent the development of hyponatremia and improve hyponatremia in cirrhotic patients during hospitalizations, which may influence the patients’ outcomes.

Keywords: human albumin; hyponatremia; liver cirrhosis; prevention; treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Flow charts of patient selection in the Hospitalization outcome (panel A) and Long-term outcome (panel B) cohorts. Abbreviations: PSM: propensity score matching; HA: human albumin.
Figure 2
Figure 2
HA infusion for the prevention and treatment of hyponatremia during hospitalizations. (Panel A): Bar plots displayed the incidence of hyponatremia in the HA and control groups, and forest plots showed the ORs with 95% CIs for the role of HA infusion for the prevention of hyponatremia. (Panel B): Bar plots displayed the rate of improvement of hyponatremia in the HA and control groups, and forest plots showed the ORs with 95% CIs for the role of HA infusion for the improvement of hyponatremia. Abbreviations: HA: human albumin; CI: confidence intervals; HCC: hepatocellular carcinoma.
Figure 3
Figure 3
Long-term survival according to the development of hyponatremia during hospitalizations. (Panel A): Kaplan–Meier curves showed the cumulative survival rates in overall patients who developed and did not develop hyponatremia during hospitalizations. (Panel B): Kaplan–Meier curves showed the cumulative survival rates in overall patients who developed and did not develop hyponatremia during hospitalizations in the HA group. (Panel C): Kaplan–Meier curves showed the cumulative survival rates in overall patients who developed and did not develop hyponatremia during hospitalizations in the control group.
Figure 4
Figure 4
Long-term survival according to the improvement of hyponatremia during hospitalizations. (Panel A): Kaplan–Meier curves showed the cumulative survival rates in overall patients who had and did not have improvement of hyponatremia during hospitalizations. (Panel B): Kaplan–Meier curves showed the cumulative survival rates in overall patients who had and did not have improvement of hyponatremia during hospitalizations in the HA group. (Panel C): Kaplan–Meier curves showed the cumulative survival rates in overall patients who had and did not have improvement of hyponatremia during hospitalizations in the control group.
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