The INFECIR-2 Albumin Prevention Study

Inclusion Criteria: * Cirrhotic patients with age ≥18 years * Diagnosis of urinary infection, pneumonia, spontaneous or secondary bacteremia, skin/soft tissue infection, acute cholangitis or suspected bacterial infection at hospital admission or during hospitalization * Patients with uncomplicated urinary infections or suspected bacterial infection will require the presence of signs of systemic inflammation: at least 1 diagnostic criterion of systemic inflammatory response syndrome (SIRS) and serum CRP levels ≥1 mg/dl (10 mg/L). This criterion will not be required for the rest of infections * Analytical data of renal and/or liver dysfunction (serum creatinine ≥ 1.2 mg/dl, serum sodium ≤ 130 mEq/l, serum bilirubin ≥4 mg/dl). Patients with pneumonia or documented bacteremia (positive blood cultures) will require the presence of at least 1 of these analytical criteria to be included in the study. Patients with urinary infection, skin/soft tissue infection, acute cholangitis or suspected bacterial infection will require 2 or more criteria for inclusion Exclusion Criteria: * \> 72h after infection diagnosis * Pregnancy * Acute or subacute liver failure without underlying cirrhosis * Septic shock * Severe acute respiratory distress syndrome (Pa02/Fi02 ≤ 100) * Active or recent variceal bleeding unless controlled for \> 48h * Ongoing type-1 HRS (past IAC criterion: serum creatinine ≥ 2.5 mg/dl) * Type-3 ACLF (defined according to the Canonic Study criteria) * Hemodialysis or othe…