Wait, Which Weight Should I Use? Evaluating Albumin Dosing Strategies in Patients with Spontaneous Bacterial Peritonitis Weighing Greater than 100 Kilograms

Document Type

Conference Proceeding

Publication Date

1-8-2025

Publication Title

Am J Health Syst Pharm

Abstract

Purpose: Spontaneous bacterial peritonitis (SBP) is an infection of the ascitic fluid commonly seen in patients with cirrhosis. Evidence-based treatment of SBP includes antibiotic and albumin administration. Albumin is administered as a 1.5 g/kg dose on day 1, and a 1 g/ kg dose on day 3, with no maximum doses. There is limited data to guide albumin dosing in patients weighing greater than 100 kg which may lead to inconsistent dosing and adverse medication related side effects. The purpose of this study is to characterize albumin dosing practices in patients with SBP weighing greater than 100 kg. Methods: This was an IRB approved, retrospective, observational study that took place at a five-hospital health-system in Southeast Michigan. Patients were included if they were greater than 18 years old, weighed greater than 100 kg, diagnosed with SBP, received an intravenous dose of albumin 25%, and were admitted between 7/01/2019 and 6/30/2024. Patients were excluded if they had a documented albumin allergy or were of the protected patient populations. The primary outcome was to describe the weight-based dose of albumin received, using actual body weight, for treatment of SBP on days 1 and 3. Secondary outcomes included evaluation of the weight based albumin dosing strategy received by ideal body weight and adjusted body weight, rates of acute kidney injury (AKI), pulmonary edema, hospital length of stay, and in-hospital mortality. AKI was defined as an increase in serum creatinine (SCr) ≥ 0.3 mg/dL within 48 hours or greater than 49% increase within 5 days from the first dose of albumin for SBP. The data will be analyzed using descriptive statistics, with Microsoft Excel and Jamovi serving as the statistical software. Categorical variables will be expressed with frequency distributions. Continuous variables will be expressed using mean, median with range, and standard deviation.

Volume

82

Issue

Supplement_1

First Page

S1482

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