ALB and Abnormal renal physiology: Nevertheless, whereas these trials provided evidence for the long-term use of albumin in patients with ascites (that is, patients at risk for kidney dysfunction and HRS), another RCT comprising a placebo group reported a lack of efficacy of long-term low-dose (40 g/15 days) albumin therapy in more advanced patients: Albumin in combination with midodrine (an alpha-1 adrenergic agonist) failed to prevent complications (including renal dysfunction) in patients awaiting LT81.