Serum-ascites albumin gradient

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The serum-ascites albumin gradient (SAAG) helps determine the cause of ascites.

The SAAG is probably a better discriminant than older measures (transudate versus exudate) for the causes of ascites.[1] A high gradient (> 1.1 g/dL) indicates the ascites is due to portal hypertension. A low gradient (< 1.1 g/dL) indicates ascites of non-portal hypertensive etiology.

SAAG = albumin concentration of serum - albumin concentration of ascitic fluid

  • Both are obtained on the same day.

[edit] References

  1. ^ Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med 1992;117:215-20. PMID 1616215.
  1. Runyon BA, Montano AA, Akriviadis EA, Antillon MR, Irving MA, McHutchison JG. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med 1992;117:215-20. PMID 1616215.

Important causes of high SAAG ascites (> 11 gm/L) include cirrhosis of the liver, Budd Chiari syndrome and heart failure.