Nonetheless, an approach to mitigate this potential limitation would be to calculate 5vMELD using a patient's albumin value prior to any albumin administration (e.g. upon hospital admission among inpatients) or their nadir value (e.g. in outpatients with refractory ascites treated with large volume paracenteses), akin to assigning a creatinine of 4 g/dL in MELD for patients on dialysis. This evidence concerns the gene ALB and Ascites.