Plasma volume expansion by albumin in cirrhosis. Relation to blood volume distribution, arterial compliance and severity of disease

J Hepatol. 2003 Jul;39(1):24-31. doi: 10.1016/s0168-8278(03)00160-0.


Background/aims: The aim of the study was to investigate the effect of a standard albumin load on blood volume distribution, arterial compliance, and the renin-angiotensin-aldosterone system in patients with different degrees of cirrhosis.

Methods: 31 patients with cirrhosis (Child classes A/B/C=8/14/9) received an intravenous infusion of 40 g human serum albumin during a haemodynamic investigation.

Results: Whereas plasma- and blood volume increased by 23 and 15%, respectively (P<0.001), a significant increase in central blood volume was found only in class A patients (+8%, P<0.05), but not in class B or class C patients (+2.7%, not significant (n.s.)). In contrast, arterial compliance only increased significantly in class C patients (+18%, P<0.05), but not in class A or class B patients (+6%, n.s.). Plasma renin activity (PRA) decreased significantly in class C patients (-31%, P<0.05). When all patients were compared, the change in arterial compliance was inversely correlated to the change in PRA (r=-0.50, P<0.01).

Conclusions: Although infusion of albumin does not expand the central blood volume in patients with advanced cirrhosis, the results indicate a significant improvement in the low effective arterial blood volume of such patients, which may be important in the prevention of circulatory dysfunction.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aldosterone / blood
  • Arteries / physiology
  • Blood Pressure / physiology
  • Compliance
  • Female
  • Humans
  • Liver Circulation / physiology
  • Liver Cirrhosis / blood*
  • Liver Cirrhosis / physiopathology*
  • Male
  • Middle Aged
  • Plasma Volume / physiology*
  • Renin / blood
  • Renin-Angiotensin System / physiology
  • Serum Albumin / metabolism*
  • Severity of Illness Index
  • Vascular Resistance / physiology


  • Serum Albumin
  • Aldosterone
  • Renin