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The serum-ascites albumin gradient (SAAG) is probably a better discriminant than older measures (transudate versus exudate) for the causes of ascites. [12] 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 as a cause. [13]
The serum-ascites albumin gradient or gap (SAAG) is a calculation used in medicine to help determine the cause of ascites. [1] The SAAG may be a better discriminant than the older method of classifying ascites fluid as a transudate versus exudate. [2] The formula is as follows: SAAG = (serum albumin) − (albumin level of ascitic fluid).
Transudate is extravascular fluid with low protein content and a low specific gravity (< 1.012). It has low nucleated cell counts (less than 500 to 1000 per microliter) and the primary cell types are mononuclear cells: macrophages, lymphocytes and mesothelial cells. For instance, an ultrafiltrate of blood plasma is transudate.
The Rivalta Test is a simple, inexpensive method that can be used in resource-limited settings to differentiate a transudate from an exudate. [1] It is a simple, inexpensive method that does not require special laboratory equipment and can be easily performed in private practice.
For example, the specific gravity of the transudate is usually less than 1.012 and a protein content of less than 2 g/100 mL (2 g%). Rivalta test may be used to differentiate an exudate from a transudate. It is not clear if there is a distinction in the difference of transudates and exudates in plants.
The fluid is a transudate and similar to fluid found in ascites. [4] There may be a higher protein and albumin content in hepatic hydrothorax due to the pleura absorbing the water. [ 5 ] To rule out heart-related causes of pleural effusion, an echocardiogram can be performed.
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An accurate diagnosis of the cause of the effusion, transudate versus exudate, relies on a comparison of the chemistries in the pleural fluid to those in the blood, using Light's criteria. According to Light's criteria (Light, et al. 1972), a pleural effusion is likely exudative if at least one of the following exists: [31]