Title: SBP, HRS, and Albumin

Category: Critical Care

Keywords: spontaenous bacterial peritonitis, hepatorenal syndrome, albumin (PubMed Search)

Posted: 5/1/2012 by Mike Winters, MBA, MD (Updated: 3/5/2026)

SBP, HRS, and Albumin

Spontaneous bacterial peritonitis (SBP) is the most common infection in patients with end-stage liver disease (ESLD).
In critically ill patients, SBP can precipitate type 1 hepatorenal syndrome (HRS), which, if not treated, carries a mortality > 90%.
Infusion of albumin at 1.5 g/kg at the time of SBP diagnosis (and a second dose of 1 g/kg on day 3) has been shown to significantly decrease the incidence of type 1 HRS and decrease mortality.
In your next critically ill patient wth ESLD, strongly consider giving albumin at the time of SBP diagnosis.

Bernardi M, et al. Human albumin in the management of complications of liver cirrhosis. Crit Care 2012; 16:211.