Correction and Prevention of Hyponatremia in Patients With Cirrhosis and Ascites: Post Hoc Analysis of the ANSWER Study Database
Giacomo Zaccherini, Maurizio Baldassarre, Manuel Tufoni, Silvia Nardelli, Salvatore Piano, Carlo Alessandria, Sergio Neri, Francesco Giuseppe Foschi, Fabio Levantesi, Giorgio Bedogni, Marco Domenicali, Mauro Bernardi, Paolo Caraceni, for the ANSWER Study Investigators
Abstract
INTRODUCTION: We assessed the impact of long-term albumin administration to hyponatremic patients with ascites enrolled in the ANSWER trial. METHODS: The normalization rate of baseline hyponatremia and the 18-month incidence rate of at least moderate hyponatremia were evaluated. RESULTS: The hyponatremia normalization rate was higher with albumin than with standard medical treatment (45% vs 28%, P = 0.042 at 1 month). Long-term albumin ensured a lower incidence of at least moderate hyponatremia than standard medical treatment (incidence rate ratio: 0.245 [CI 0.167-0.359], P < 0.001). DISCUSSION: Long-term albumin administration improves hyponatremia and reduces episodes of at least moderate hyponatremia in outpatients with cirrhosis and ascites.