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).
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