ACCURACY OF SERUM - ASCITES ALBUMIN GRADIENT IN THE AETIOLOGICAL DIAGNOSIS OF ASCITES

Area of Science:

• Gastroenterology and Hepatology
• Internal Medicine
• Diagnostic Medicine

Background:

• Ascites is a common clinical condition requiring accurate diagnosis of its underlying cause.
• Portal hypertension is a frequent etiology of ascites, necessitating reliable diagnostic tools.
• Distinguishing between high and low serum-ascites albumin gradient (SAAG) and exudative vs. transudative ascites are key diagnostic approaches.

Purpose of the Study:

• To evaluate the diagnostic performance of SAAG and ascitic fluid protein levels in identifying portal hypertension as a cause of ascites.
• To assess the sensitivity, specificity, and predictive values of these parameters.
• To compare the utility of SAAG versus the exudate-transudate classification for ascites diagnosis.

Main Methods:

• A study involving 50 adult patients with ascites admitted to the hospital.
• Simultaneous collection of ascitic fluid and blood samples for analysis.
• Measurement of ascitic fluid total protein and serum ascites albumin gradient (SAAG), with established cut-off values for classification.

Main Results:

• High SAAG demonstrated high sensitivity (94.3%) in diagnosing portal hypertension.
• The exudate-transudate approach showed limitations, with specificities and predictive values varying significantly.
• High SAAG ascites is identified as a sensitive indicator for diagnosing portal hypertension.

Conclusions:

• The serum-ascites albumin gradient is a highly sensitive diagnostic marker for portal hypertension in ascites.
• The exudate-transudate classification method presents considerable limitations in the differential diagnosis of ascites.
• SAAG is a more reliable parameter than ascitic fluid protein content for diagnosing the cause of ascites.