Human albumin infusion for reducing hyponatremia and circulatory dysfunction in liver cirrhosis: A meta-analysis update

Table 1 Baseline characteristics of the included studies

Ref.	Design	Intervention	Trial arms	Total subjects	Age (years, mean ± SD)	Baseline hyponatremia, n (%)	Quality assessment1
Ginès et al[51], 1988	RCT	Paracentesis plus IV albumin infusion	Paracentesis plus IV albumin infusion	52	56 ± 22	NA	3
			Paracentesis without IV albumin infusion	53	58 ± 22	NA
Sola-Vera et al[54], 2003	RCT	Paracentesis + albumin	Paracentesis + albumin	37	59.9 ± 10.9	8	3
			Paracentesis + saline	35	62.9 ± 10.7	13
García-Compean et al[50], 2002	RCT	Large-volume paracentesis + albumin	Large-volume paracentesis + albumin	48	58.9 ± 15.9	6 (12)	3
			Large-volume paracentesis + Dextran 40	48	59.4 ± 11.2	5 (10)
Planas et al[52], 1990	RCT	Total paracentesis + IV albumin infusion	Total paracentesis + IV albumin infusion	43	59 ± 1.52	NA	3
			Total paracentesis + IV Dextran 70 infusion	45	59 ± 1.42	NA
Bajaj et al[39], 2018	Retrospective	With albumin	With albumin	777	55.86 ± 10.24	476	7
			Without albumin	349	56.73 ± 11.31	175
Singh et al, 2006[55]	RCT	Albumin	Albumin	20	46.3 ± 12	NA	2
			Terlipressin	20	47.7 ± 8.3	NA
Moreau et al, 2002[56]	Pilot RCT	Paracentesis + albumin	Paracentesis + albumin	10	58 ± 22	NA	5
			Paracentesis + terlipressin	10	50 ± 22	NA
Salerno et al[57], 1991	RCT	Albumin infusion	Albumin infusion	27	55.9 ± 1.5	NA	2
			Hemaccel	27	53.2 ± 2	NA
García-Compeán et al[58], 1993	RCT	Total therapeutic paracentesis + albumin	Total therapeutic paracentesis + albumin	17	54.6 ± 10.9	NA	3
			Total therapeutic paracentesis without albumin	18	56.7 ± 7.8	NA
Fassio et al[59], 1992	RCT	Paracentesis with albumin	Paracentesis with albumin	21	54 ± 8	NA	2
			Paracentesis with Dextran 70	20	54 ± 7	NA
Altman et al[60], 1998	RCT	Albumin	Albumin	33	55.9 ± 11.2	NA	3
			Hydroxyethyl starch	27	56.3 ± 11.2	NA
Singh et al[61], 2006	Pilot RCT	Albumin	Albumin	20	52.5 ± 9.9	NA	2
			Noradrenaline	20	43.9 ± 9.5	NA
Appenrodt et al[37], 2008	Pilot RCT	Albumin	Albumin	13	60 (50-63)4	NA	3
			Midodrine	11	52 (48-61)	NA
Abdel-Khalek and Arif[13], 2010	Prospective RCT	Paracentesis + albumin	Paracentesis + albumin	68	47.97 ± 2.54	NA	2
			Paracentesis + hydroxyethyl starch 6%	67	46 ± 2.96	NA
Salerno et al[62], 1987	RCT	Repeated paracenteses + IV albumin infusion	Repeated paracenteses + IV albumin infusion	20	53.7 ± 2.8	NA	1
			Diuretics	21	56.4 ± 2.1	NA
Moreau et al[63], 2006	Pilot RCT	Albumin	Albumin	30	54 ± 9.0	NA	5
			Polygeline	38	56 ± 8.0	NA
Jalan et al[64], 2007	RCT	Human salt poor albumin + fluid + Na restriction	Human salt poor albumin + fluid + Na restriction	12	-	NA	1
			Fluid restriction (1.5 L) + Na restriction (80 mmol/day)	12	-	NA
Sort et al[40], 1999	RCT	Cefotaxime + IV albumin	Cefotaxime + IV albumin	63	60 ± 1.02	NA	3
			IV cefotaxime	63	62 ± 1.02	NA
Bari et al[65], 2012	Prospective, DB RCT	Albumin	Albumin	13	55 (51-61)3	NA	5
			Octreotide + midodrine	12	60 (51-65)3	NA
Solà et al[25], 2018	DB RCT	Midodrine and albumin	Midodrine and albumin	87	55 ± 10	NA	5
			Placebo	86	54 ± 11	NA
Caraceni et al[24], 2018	Open-label RCT	SMT + human albumin	SMT + human albumin	218	61.0 ± 11.4	75	3
			SMT	213	61.4 ± 10.9	74
Hu et al[38], 2023	Retrospective analysis	Albumin	Albumin	1093	58 (51-66)3	NA	6
			Non-albumin	1172	60 (52-67)3	NA
Khanna et al[66], 2024	Single-center prospective case-control	SMT + human albumin	SMT + human albumin	88	55.25 ± 11.5	NA	6
			SMT	86	55.0 ± 11.3	NA
Di Pascoli et al[67], 2019	Nonrandomized prospective	Albumin	Albumin	45	64.2 ± 10.4	NA	5
			SOC	25	65.5 ± 12.7	NA
Guevara et al[68], 2012	RCT	Albumin	Albumin	46	56 ± 10	NA	3
			Control	51	56 ± 12	NA
Thévenot et al[69], 2015	Randomized, open-label, controlled, multicenter, clinical trial	Albumin	Albumin	95	55.4 ± 8.3	NA	3
			Control	96	55.3 ± 9.0	NA
Devisetty et al[70], 2024	Prospective, non-inferiority, open-label RCT	Antibiotics and SMT+ Albumin	Antibiotics and SMT+ Albumin	58	52.52 ± 13.54	NA	3
			Antibiotics and SMT+ Albumin	116	54.34 ± 12.84	NA
Simón-Talero et al[71], 2013	Multicenter, prospective, DB, controlled trial	Albumin	Albumin	26	63.7 ± 11.3	NA	5
			Isotonic saline	30	66.3 ± 9.7	NA
Romanelli et al[72], 2006	Unblinded randomized trial	Diuretics + albumin	Diuretics + albumin	54	63 (44 - 70)3	NA	3
			Diuretics	46	63 (47-70)3	NA
Abootalebi et al[73], 2017	RCT	Albumin	Albumin	36	Total population mean age: 45.48 ± 3.95	NA	4
			HES	36		NA
			HES + albumin	36		NA
Boyer et al[74], 2016	Phase 3, multicenter, randomized, DB, placebo-controlled trial		Terlipressin + albumin	97	55.8 ± 8.4	NA	4
			Terlipressin	99	54.8 ± 8.5

¹Quality assessment of the randomized controlled trials was performed done using the Jadad scale and observational non-randomized controlled trial using the Newcastle-Ottawa scale.

²Values are expressed as mean (SE).

³Values are expressed as median (range).

⁴values are expressed in mean (range).

DB: Double-blind; HES: Hydroxyethyl starch; IV: Intravenous; RCT: Randomized controlled trial; SOC: Standard of care; SMT: Standard medical therapy.