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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).
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 (SAAG) is the most useful index for evaluating peritoneal fluid and can help distinguish ascites caused by portal hypertension (cirrhosis, portal vein thrombosis, Budd-Chiari syndrome, etc.) from other causes of ascites. SAAG is calculated by subtracting the albumin measure of ascitic fluid from the serum value.
The serum-ascites albumin gradient can help determine the cause of the ascites. [7] The color of the ascitic fluid can also be useful in analysis. Blood fluid can indicate trauma or malignancy. A milky appearance of the fluid can indicate lymphoma or malignant peritoneal ascites. Cloudy or turbid fluid can indicate possible infection or ...
Diagram showing fluid (ascites) being drained from the abdomen. Date: 30 July 2014 (released by CRUK) Source: Original email from CRUK: Author: Cancer Research UK: Permission (Reusing this file) This image has been released as part of an open knowledge project by Cancer Research UK. If re-used, attribute to Cancer Research UK / Wikimedia Commons
Increase in serum creatinine >0.3mg/L 26umol/L within 48 hrs OR increase by >1.5 times from baseline (reading from the last 3 months) No response to withdrawal of diuretics or administration of 1g/kg of albumin 20% over the last 2 days; Cirrhosis with ascites; Absence of Shock state; Current or recent use of nephrotoxins (eg. NSAIDS, contrast dyes
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