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. 2025 Jun 14;17(6):e86016.
doi: 10.7759/cureus.86016. eCollection 2025 Jun.

Assessment of Albumin Therapy and Paracentesis Interval in Cirrhotic Patients With Recurrent Ascites: A Prospective Cohort Study

Muhammad Abdullah Khan  1 , Hafiz Muhammad Faizan Mughal  2 , Shehwar Ahmed  3 , M Khaliq  4 , Abdul Ghafoor  5
Affiliations

Assessment of Albumin Therapy and Paracentesis Interval in Cirrhotic Patients With Recurrent Ascites: A Prospective Cohort Study

Muhammad Abdullah Khan et al. Cureus. .

Abstract

Background and aim: Many people with liver cirrhosis develop recurrent ascites that requires repeated treatments of large-volume paracentesis (LVP). This study aimed to determine whether intravenous albumin treatment extends the interval between paracentesis procedures, while also preventing paracentesis-induced circulatory dysfunction (PICD) and renal dysfunction among cirrhotic patients who experience recurrent ascites.

Methods: This prospective cohort study was carried out at a tertiary care hospital in Pakistan from April 2023 to August 2023, including 120 patients undergoing LVP treatment for cirrhosis were divided into two equal groups. OpenEpi version 3.0.0 (released 2013, developed by Andrew G. Dean, Kevin M. Sullivan, and Daniel G. Soe, Atlanta, GA, USA) was used for calculation. The 60 patients in Group A received albumin, while 60 in Group B received only saline. Over four months, outcomes were evaluated. The statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York, United States).

Results: Group A experienced a prolonged time interval between paracentesis treatments (18.2 vs. 11.1 days, p < 0.001) and a reduced occurrence of PICD (7 (11.7%) vs. 23 (38.3%), p = 0.001) and renal dysfunction (6 (10.0%) vs. 18 (30.0%), p = 0.008). The patients in Group A experienced reduced incidents of hospitalizations, together with emergency procedures. This highlighted the greater efficacy of albumin than saline.

Conclusion: Using albumin in therapy decreased the risks of recurring fluid buildup in cirrhotic patients, as it helped in prolonging the time between repeated fluid removal procedures. However, due to a single-center approach, the generalizability of the results was limited. Nonetheless, albumin administration at the standardized intervals should become part of the therapeutic regimen because it ensures patients' safety and reduces the workload on medical staff.

Keywords: albumin therapy; cirrhosis; fluid management; paracentesis; picd; recurrent ascites; renal dysfunction.

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Conflict of interest statement

Human subjects: Informed consent for treatment and open access publication was obtained or waived by all participants in this study. Federal Postgraduate Medical Institute, Lahore issued approval 23/1455. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

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