How do you calculate serum albumin ascites gradient?
Calculation of SAAG is performed by measuring the serum albumin and ascitic fluid albumin concentrations simultaneously and then subtracting the ascitic fluid albumin from the serum albumin. A SAAG of >1.1 g/dL is 97% accurate in detecting portal hypertension (Fig.
Is albumin high or low in ascites?
Ascites albumin levels in patients with cirrhosis and portal hypertension are typically less than 1 g/dL7 (Figure 1). Low SAAG ascites (<1.1 g/dL) is usually caused by perito- neal malignancies, chronic peritoneal infection (i.e., myco- bacterium tuberculosis), and nephrotic syndrome.
What is the level of serum ascites albumin gradient SAAG of a serous fluid from Transudative effusion?
Peritoneal fluid albumin is used to calculate the serum-ascites albumin gradient (SAAG). Values of 1.1 g/dL or higher suggest portal hypertension. Pleural fluid albumin may be used to calculate a serum-effusion albumin gradient. Values above 1.2 g/dL are most consistent with a transudative process.
What is a normal SAAG?
Under normal circumstances the SAAG is < 1.1 because serum oncotic pressure (pulling fluid back into circulation) is exactly counterbalanced by the serum hydrostatic pressure (which pushes fluid out of the circulatory system).
Can you have ascites with normal albumin levels?
Background: Ascites usually occurs in the setting of end-stage liver disease and low serum albumin and is associated with increased mortality. However, some patients develop ascites despite normal serum albumin (NSA), when a higher portal pressure and/or enhanced renal sodium retention would be expected.
What is high SAAG ascites?
The SAAG correlates with the sinusoidal pressure,6 and a SAAG ≥1.1 g/dL (high SAAG ascites) indicates a hepatic vein–portal vein pressure gradient more than 11 mm Hg (i.e., portal hypertension). High SAAG ascites is almost always caused by a sinusoidal or postsinusoidal source of the ascites.
What is the normal range of SAAG?
How do you evaluate ascites?
- Assessment for Ascites. Physicians should be familiar with the signs of ascites and physical examination maneuvers that can be used to detect ascites.
- Signs of Ascites. • Increase in abdominal girth and weight gain.
- Fluid Wave Test. • Patient lies supine.
- Shifting Dullness Test. • Patient lies supine.
What level of albumin indicates cirrhosis?
With liver cirrhosis, the serum albumin value (reference range: 3.8 to 5.1g/dL) decreases by an average of 0.15g/dL per year, and for the patients with a low serum albumin value (less than 3.5g/dL), the 5-year survival rate drops considerably.
What is normal albumin level in ascitic fluid?
Table 1
| Test | Patient’s Laboratory Values | Reference Range |
|---|---|---|
| Alanine aminotransferase, U/L | 9 | 14–54 |
| Alkaline phosphatase, U/L | 42 | 24–110 |
| Total bilirubin, mg/dL | 0.6 | 0.4–1.5 |
| Albumin, g/dL | 2.5 | 3.5–4.8 |
What are the differential diagnosis of ascites?
The most common cause of ascites is portal hypertension in 80– 85% of the cases; malignancy, cardiac failure, abdominal tuberculosis and others are less common causes. A diagnostic paracentesis should be performed in the initial evaluation of ascites to determine the cause of ascites and to make the diagnosis of SBP.
How is albumin ascites gradient measured?
Measurement of the serum albumin ascites gradient (SAAG) is both a highly accurate and clinically facile technique for assessing the origins of ascites. The SAAG is calculated by subtracting the concentration of albumin in the ascites from that in the plasma.
What is the serum-ascites albumin gradient?
This gradient is physiologically based on oncotic-hydrostatic balance and is related directly to portal pressure. The serum-ascites albumin gradient is calculated by subtracting the albumin concentration of ascitic fluid from the albumin concentration of serum obtained on the same day:
What is the normal protein content of albumin ascites?
The fluid protein is typically less than 2.5 mg/dL, and the protein content varies inversely with the severity of the portal hypertension (Hoefs, 1983). Measurement of the serum albumin ascites gradient (SAAG) is both a highly accurate and clinically facile technique for assessing the origins of ascites.
What is the normal range for serum minus ascites?
A serum minus ascites albumin value of less than 1.1 g/mL (Chapter 156) supports the diagnosis of malignant ascites but is also seen in pancreatitis, nephrotic syndrome, and peritoneal tuberculosis. In the setting of hepatic metastases, the serum-ascites albumin gradient may be greater than 1.1.