Albumin for end-stage liver disease

Korean J Intern Med. 2012 Mar;27(1):13-9. doi: 10.3904/kjim.2012.27.1.13. Epub 2012 Feb 28.


Albumin has been widely used in patients with cirrhosis in an attempt to improve circulatory and renal functions. The benefits of albumin infusions in preventing the deterioration in renal function associated with large-volume paracentesis, spontaneous bacterial peritonitis, and established hepatorenal syndrome in conjunction with a vasoconstrictor are well established. While some of these indications are supported by the results of randomized studies, others are based only on clinical experience and have not been proved in prospective studies. The paucity of well-designed trials, the high cost of albumin, the lack of a clear-cut survival benefit, and fear of transmitting unknown infections make the use of albumin controversial. The recent development of the molecular adsorbent recirculating system, an albumin dialysis, is an example of the capacity of albumin to act by mechanisms other than its oncotic effect. Efforts should be made to define the indications for albumin use, the dose required, and predictors of response, so that patients gain the maximum benefit from its administration.

Keywords: Albumins; Ascites; Encephalopathy; Hepatorenal syndrome; Liver cirrhosis; Peritonitis.

Publication types

  • Review

MeSH terms

  • Albumins / administration & dosage*
  • Albumins / adverse effects
  • Ascites / therapy
  • End Stage Liver Disease / physiopathology
  • End Stage Liver Disease / therapy*
  • Evidence-Based Medicine
  • Hepatorenal Syndrome / therapy
  • Humans
  • Liver Cirrhosis / therapy
  • Plasma Substitutes / administration & dosage*
  • Plasma Substitutes / adverse effects
  • Sorption Detoxification / adverse effects
  • Sorption Detoxification / methods*
  • Treatment Outcome


  • Albumins
  • Plasma Substitutes