ALB and Renal insufficiency: The EASL clinical practice guidelines and Billroth III consensus guidelines recommend the use of albumin in patients with cirrhosis undergoing a large-volume paracentesis (LVP) to prevent paracentesis-induced circulatory dysfunction (PICD), as well as in patients with SBP or hepatorenal syndrome (HRS-AKI) [1, 2, 22, 23].