Serum-Ascites Albumin Gradient
February 15th, 2021
Overview
The serum-ascites albumin gradient (SAAG) is used to differentiate between portal hypertension and other causes of ascites.
Formula
- SAAG = [serum albumin] - [ascitic albumin]
Elevated Serum-Ascites Albumin Gradient
Elevated SAAG (>1.1 g/dL) is indicative of portal hypertension.
Causes of Ascites with Elevated SAAG
- Cirrhosis
- Cardiac ascites
- Alcoholic hepatitis
- Massive liver metastasis
- Fulminant hepatic failure
- Portal venous thrombosis
Reduced Serum-Ascites Albumin Gradient
Ascites with a low SAAG (<1.1 g/dL) is suggestive of a non-portal hypertension cause of ascites.
Causes of Ascites with Reduced SAAG
- Infection - bacterial peritonitis, pancreatitis, TB
- Malignancy
- Nephrotic syndrome
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