Albumin Administration Linked to Lower Risk of Hyponatremia in Hospitalized Cirrhosis Patients: Single-Center Study

Short-term human albumin (HA) infusion significantly reduced the incidence of hyponatremia and increased the rate of improvement of hyponatremia in hospitalized hepatic cirrhosis patients, according to a retrospective study of 2,414 patients consecutively admitted to a single Chinese hospital between 2010 and 2014 (the “hospitalization outcome” cohort), and another 339 patients admitted between 2014 and 2021 (the “long-term outcome” cohort).

In the hospitalization outcome cohort, the HA group was found to have a significantly lower incidence of hyponatremia than the control group (16.3% versus 41.9%; p < 0.001). Logistical regression analysis also showed HA infusion (median total dosage: 30 g; range: 10-530 g) was associated with decreased risk of developing hyponatremia during hospitalization (odds ratio [OR], 0.27; 95% confidence interval [CI], 0.184-0.396; p < 0.001). Patients who developed hyponatremia during hospitalization had a significantly higher in-hospital mortality than those who did not (7.1% versus 3.0%, p < 0.001), a mortality divergence seen in both the HA (10.4% versus 4.3%) and control (5.6% versus 2.3%; p = 0.003) groups.

Among the 291 patients in the long-term outcome cohort with normal serum sodium level at admission, those assigned to receive HA has a significantly lower incidence of hyponatremia than controls (7.7% versus 30.8%); the median total dosage of HA was again 30 g (range: 10-150 g). Again, HA infusion was significantly associated with reduced risk of developing hyponatremia during hospitalization (OR, 0.188; p = 0.016). Consistent with the hospitalization outcome cohort, development of hyponatremia during hospitalization was found to be associated with decreased long-term survival (HR, 0.400; 95% CI, 0.26-0.616; p < 0.001).