Albumin Administration Guidelines

Indication-Specific Dosing

For patients with congenital nephrotic syndrome, base albumin infusion on clinical indicators of hypovolaemia, such as prolonged capillary refill time, tachycardia, hypotension, oliguria, and abdominal discomfort, rather than serum albumin levels, as recommended by the National Kidney Foundation 1, 2
Daily albumin infusions of 1–4 g/kg may be initiated for patients with severe congenital nephrotic syndrome, according to the American Academy of Pediatrics 1, 3
Consider administering a dose of furosemide (0.5–2 mg/kg) at the end of each albumin infusion, unless the patient has marked hypovolaemia and/or hyponatraemia, as suggested by the European Renal Association 3, 4
For large volume paracentesis (>5L), administer albumin at a dose of 8g per liter of ascites removed after the procedure is completed, as recommended by the American Association for the Study of Liver Diseases 5, 6
For spontaneous bacterial peritonitis, administer 1.5 g/kg on day 1 and 1 g/kg on day 3, according to the Infectious Diseases Society of America 7

When administering furosemide with albumin, infuse over 5–30 minutes to minimize ototoxicity, as recommended by the National Institute of Diabetes and Digestive and Kidney Diseases 3
Monitor fluid status, electrolytes, blood pressure, and kidney function during administration, as suggested by the American Heart Association 3
For patients receiving regular albumin infusions via central venous lines, consider prophylactic anticoagulation, according to the American College of Chest Physicians 2, 8

Home administration of albumin by trained caregivers is feasible and safe for selected patients requiring long-term therapy, as recommended by the National Kidney Foundation 9