Friday, June 12, 2015

Study group discussion: Serum ascites albumin gradient

Can anyone explain the serum ascites albumin gradient in a super simplified way?

High SAAG: Imbalance between hydrostatic and portal pressures.

Low SAAG: Ascites due to protein leakage.

SAAG = Serum albumin - Albumin in ascitic fluid. And is directly proportional to portal pressure.

So if SAAG increases, it means portal pressure has increased?

Yes. So high SAAG indicates pathology of ascites related to increased portal pressure / liver pathology.

And what about low SAAG?

Low SAAG suggests peritoneal causes of ascites like tuberculous peritonitis, peritoneal carcinomatosis, etc. The are mostly exudative causes.

What is SAAG in nephrotic syndrome?
Low.

What is SAAG in CHF?
High.

Related post: Exudate & Transudate

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