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How to determine the cause of Ascites in Ascites fluid using SAAG test?

SAG Testing Simplified:
SAG or SAAG is a short-form “serum-ascites albumin gap”
SAG is used to assess in id. of cause of ascites

Ascites definition:
Ascites caused due to the accumulation of fluid in the peritoneal cavity, causing abdominal swelling.
In other words:
Ascites is the build up of fluid in the space between the lining of the abdomen and abdominal organs (the peritoneal cavity).

Common Symptoms of Patients present with the insidious onset of ascites , abdominal pain, and fever.

How to Calculate SAAG?
SAAG = (albumin concentration of serum) – (albumin concentration of ascitic fluid).

SAAG Interpretation for better understanding of what causes Ascites?

Normal-SAAG is less than 1.1
Means Pressure in/out Circulation is in Balance

High-SAAG is (greater than 1.1 g/dL)
Means Ascites is due to portal hypertension:
Low protein in ascitic fluid (Less than 2.5 g/dL but greater than 1.1 g/dL): cirrhosis of the liver
High protein in ascitic fluid (more than 2.5 g/dL): heart failure, Budd-Chiari syndrome

Low-SAAG is (smaller than 1.1 g/dL )
Means Ascites is of peritoneal Reasons such as peritoneal tuberculosis, pancreatitis, nephrotic syndrome, serositis, and various types of peritoneal cancer (peritoneal carcinomatosis).

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