Serum-ascites albumin gradient (SAAG) is more useful than the total protein concentration of ascitic fluid in the classification of ascites. This gradient is physiologically based on oncotic-hydrostatic balance and is related directly to portal pressure.
Thereof, why is SAAG high in ascites?
The increase in hydrostatic pressure causes more fluid to leave the circulation into the peritoneal space (ascites). The SAAG subsequently increases because there is more free fluid leaving the circulation, concentrating the serum albumin.
Considering this, what does a SAAG score mean?
The SAAG is a physiological clinical diagnostic tool for the evaluation of ascites. An increased SAAG (> 1.1 gm/dL) value indicates the presence of portal hypertension, which is detected by observing portal hypertensive changes in the upper gastrointestinal tract.
What does low SAAG mean?
A low gradient (SAAG < 1.1 g/dL) indicates nonportal hypertension and suggests a peritoneal cause of ascites. Such conditions may include the following: Primary peritoneal mesothelioma. Secondary peritoneal carcinomatosis.
How do you interpret a SAAG ratio?
A high SAAG (>1.1g/dL) suggests the ascitic fluid is a transudate
- Malignancy.
- Infection.
- Pancreatitis.
- Nephrotic syndrome.
Why SAAG is low in nephrotic syndrome?
Low SAAG ascites (<1.1 g/dL) is usually caused by peritoneal malignancies, chronic peritoneal infection (i.e., mycobacterium tuberculosis), and nephrotic syndrome. Cancers that spread to the omentum and result in ascites are typically of ovarian, gastric, or pancreatic origin.