The Causes Of Ascites – “Serum Ascites Albumin Gradient (SAAG) Interpretation” From

This post contains excerpts from Serum Ascites Albumin Gradient (SAAG) Interpretation
Updated: Dec 04, 2018 of

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]


Fulminant hepatic failure

Veno-occlusive disease

Hepatic vein obstruction (ie, Budd-Chiari syndrome)

Congestive heart failure

Nephrotic syndrome

Protein-losing enteropathy



Ovarian tumors

Pancreatic ascites

Biliary ascites



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)


Foreign bodies (ie, talc, cotton and wood fibers, starch, barium)

Systemic lupus erythematosus

Henoch-Schönlein purpura

Eosinophilic gastroenteritis

Whipple disease




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