Interpreting Low Serum-Ascites Albumin Gradient in Patients with Cirrhosis

In a study of patients with cirrhosis and low SAAG, only a small percentage had complicating factors beyond portal hypertension.

The serum-ascites albumin gradient (SAAG; the difference between ascitic fluid and serum albumin) is used widely to distinguish between portal hypertension and other causes of ascites. This study suggests that interpretation of a SAAG <1.1 g/dL (implying a cause other than portal hypertension) can be problematic in patients with cirrhosis.

Researchers at a Texas Veterans Affairs hospital identified 92 patients during 5 years who had undergone paracentesis and who had a SAAG <1.1 g/dL; 76 had documented cirrhosis. Despite extensive evaluation of these patients with a low SAAG and cirrhosis, another cause of ascites — most often, bacterial peritonitis or peritoneal carcinomatosis — was found in only 29 (38%). Of the remaining 47 patients, 33 h…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose