Ascites (serum - ascites albumin gradient < 1.1 g/Dl)

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 low serum-ascites albumin gradient (of less than 1.1 g/dL) include:
    • Peritoneal carcinomatosis
    • Pancreatitis
    • Biliary pancreatitis
    • Peritoneal tuberculosis
    • Chlamydia/gonococcal infection
    • Nephrotic syndrome
    • Connective tissue diseases

Reference:

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.