High-dosage human albumin infusion may be superior for hypervolemic hyponatremia in cirrhosis with ascites

Human albumin (HA) infusion may be effective for improving hypervolemic hyponatremia in cirrhosis. However, it remains unclear about whether HA dosage can influence its efficacy. Overall, 288 cirrhotic patients with ascites and hypervolemic hyponatremia were retrospectively included and divided into high-dosage (&gt;80 g) and low-dosage (≤80 g) HA groups during the period from the first hyponatremia diagnosis to the last HA infusion. Multivariate logistic regression analyses were performed to explore the impact of HA dosage on hyponatremia and serum albumin (ALB) level, and evaluate the impact of improvement of ALB on hyponatremia. Subgroup analyses were performed according to the baseline serum ALB level. High-dosage HA was independently associated with normalization of hyponatremia (OR = 1.919, <i>p</i> = 0.040) and improvement of ALB (OR = 3.001, <i>p</i> &lt; 0.001). The effect of high-dosage HA on normalization of hyponatremia (OR = 2.108, <i>p</i> = 0.028) and improvement of ALB (OR = 2.926, <i>p</i> = 0.001) remained significant in patients with a baseline ALB level of &lt;30 g/L. Improvement of ALB was independently associated with normalization of hyponatremia (OR = 2.108, <i>p</i> = 0.014). The effect remained significant in patients with a baseline ALB level of &lt;30 g/L (OR = 2.228, <i>p</i> = 0.019). High-dosage HA should be superior to low-dosage HA for correcting hypervolemic hyponatremia in cirrhosis, especially in those with a baseline ALB level of &lt;30 g/L, probably due to its significant benefit in the improvement of ALB.