Intravenous Albumin Administration in Nafld-Related Decompensated Liver Disease With Ascites and Bacterial Infection: A Meta Analysis

· Background: NAFLD is an emerging cause of cirrhosis and decompensated liver disease. Patients frequently develop ascites and bacterial infections, particularly spontaneous bacterial peritonitis (SBP): leading to acute kidney injury (AKI): prolonged hospitalization, ICU admission, and mortality. Intravenous albumin is widely used as an adjunct therapy due to its volume-expanding and immunomodulatory effects. · Objective: To evaluate the clinical impact of intravenous albumin administration on outcomes in patients with NAFLD-related decompensated liver disease presenting with ascites and bacterial infections. · Methods: A systematic literature review was conducted following PRISMA guidelines. Electronic databases including PubMed, Scopus, Web of Science, and Google Scholar were searched. Randomized controlled trials (RCTs) and observational studies reporting outcomes related to renal dysfunction, infection resolution, ascites resolution, hospital stay, ICU admission, and mortality were included. · Results: A total of 900 records were identified. After removal of duplicates and screening, 12 studies were included (4 RCTs and 8 observational studies). Albumin therapy demonstrated improved ascites resolution, infection resolution, reduced AKI, decreased ICU admissions, shorter hospital stay, and lower short-term mortality, with the strongest evidence in SBP patients.Conclusion: Intravenous albumin, when used early as an adjunct to antibiotic therapy, improves renal and survival outcomes in infection-related decompensated liver disease, particularly SBP. Further NAFLD-specific trials are required to optimize dosing and patient selection