This post contains excerpts from Serum Ascites Albumin Gradient (SAAG) Interpretation
Updated: Dec 04, 2018 of emedicine.medscape.com
SAAG Interpretation
The serum ascites albumin gradient (SAAG) is a formula used to assist in determining the etiology of ascites. Also see Medscape’s Ascites Albumin Gradient Calculator.
The formula is below.
SAAG = serum albumin – ascites albumin
A high gradient (SAAG >1.1 g/dL) indicates portal hypertension and suggests a nonperitoneal cause of ascites. Such conditions may include the following: [1]
Cirrhosis
Fulminant hepatic failure
Veno-occlusive disease
Hepatic vein obstruction (ie, Budd-Chiari syndrome)
Congestive heart failure
Nephrotic syndrome
Protein-losing enteropathy
Malnutrition
Myxedema
Ovarian tumors
Pancreatic ascites
Biliary ascites
Malignancy
Trauma
Portal hypertension
A low gradient (SAAG < 1.1 g/dL) indicates nonportal hypertension and suggests a peritoneal cause of ascites.
Such conditions may include the following: [1]
Primary peritoneal mesothelioma
Secondary peritoneal carcinomatosis
Tuberculous peritonitis
Fungal and parasitic infections (eg, Candida, Histoplasma, Cryptococcus, Schistosoma mansoni, Strongyloides, Entamoeba histolytica)
Sarcoidosis
Foreign bodies (ie, talc, cotton and wood fibers, starch, barium)
Systemic lupus erythematosus
Henoch-Schönlein purpura
Eosinophilic gastroenteritis
Whipple disease
Endometriosis
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