Table 3.

Human albumin dosage for each indication and corresponding rational

Indication	Dosage of administration of albumin 20%	Rational
Post-paracentesis	8 g/L of ascites removed	To prevent further reduction of effective blood volume (post-paracentesis circulatory dysfunction)
Muscle cramps	25 g once a week for 4 weeks	To reduce the frequency of muscle cramps by improving effective circulating volume
Long-term administration (in particular, in patients with uncomplicated ascites)	40 g twice a week for 2 weeks and then 40 g weekly	Human albumin administration improves effective blood volume by attenuating peripheral arterial vasodilation, prevents renal dysfunction, enhances cardiac inotropism and reduces systemic inflammation and endothelial dysfunction, acting as an antioxidant agent. This leads to an improvement of survival and a reduction in the occurrence of spontaneous bacterial peritonitis, sepsis, hepatorenal syndrome type 1, hepatic encephalopathy grade, as well as the evolution rate to refractory ascites and the need of paracentesis
Renal impairment (AKI stage >1A without obvious cause)	1 g/kg body weight for two consecutive days	Human albumin prevents HRS-AKI occurrence
HRS-AKI	20–40 g/day	Human albumin reduces systemic inflammation and microvascular dysfunction, besides improving blood volume
SBP	1.5 g/kg at diagnosis and 1 g/kg on day 3	Human albumin prevents HRS-AKI occurrence

AKI: acute kidney injury; HRS: hepatorenal syndrome; SBP: spontaneous bacterial peritonitis