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Ascites (serum - ascites albumin gradient >= 1.1 g/DL)

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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The serum-ascites albumin gradient is calculated via substracting the concentration of the ascites fluid albumin from serum albumin.

  • a serum-ascites albumin gradient of more than or equal to 1.1 g/dL predicts portal hypertension with greater accuracy than the transudate/exudate classification
    • causes of a high serum-ascites albumin gradient include:
      • Cirrhosis
      • Congestive heart failure
      • Fulminant hepatic failure
      • Alcoholic hepatitis
      • Liver metastases
      • Veno-occlusive disease
      • Portal vein thrombosis
      • Budd?Chiari syndrome


  1. Baccaro ME et al. Ascites. Medicine 2007; 35 ( 2): 104-107
  2. Runyon BA et al. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med 1992; 117: 215?220.

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