Serum ascites albumin gradient

Last revised by Dr Jeremy Jones on 10 Sep 2021

The serum–ascites albumin gradient (SAAG) is the difference between the concurrently obtained serum albumin concentration and the albumin concentration of the ascitic fluid obtained during paracentesis

Pathology

A difference ≥1.1 grams/deciliter (g/dL) indicates portal hypertension as the likely etiology, whereas a gradient which is <1.1 g/dL implies an etiology that causes increased vascular permeability in the portal system.

Differential diagnosis

A (partial) differential diagnosis of potential etiology, based on the SAAG, is as follows 2:

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Cases and figures

  • Case 1: pancreatic ascites
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  • Case 2: tuberculous peritonitis
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