In patients with ascites, a low SAAG (serum-ascites albumin gradient) <1.1 g/dl is usually thought to be caused by non-portal hypertensive etiologies. However, in this cohort of 76 cirrhotic patients withlow SAAG, the etiology could be identified in only 38% (bacterial peritonitis, malignancy, nephrotic syndrome). In non-cirrhotics, the etiology could be identified in 75% of cases. In those cirrhotics who had a repeat paracentesis to determine etiology, 73% had a high SAAG on repeat paracentesis. In patients with cirrhosis, the predictive value of SAAG in determining etiology of ascites is low (abstract).
Dr. Scheurer is a clinical hospitalist and the Medical Director of Quality and Safety at the Medical University of South Carolina in Charleston, South Carolina, and is Assistant Professor of Medicine. She is a graduate of the University of Tennessee College of Medicine, completed her residency at Duke University, and completed her Masters in Clinical Research at the Medical University of South Carolina. She also serves as the Web Editor and Physician Advisor for the Society of Hospital Medicine.