A study on serum ascites albumin gradient in the etiological diagnosis of ascites

Abstract

Aim: To study the “Serum ascites albumin gradient in the etiological diagnosis of ascites” Methodology: A total of fifty adult patients with ascites, admitted to the Department of General Medicine, NRI Medical College, Guntur within one year period, whose etiological diagnosis had not been known previously were studied prospectively. The protocol was approved by the hospital’s ethical committee and an informed consent was obtained from all patients. Results: In the present study, considering the etiology of ascites in the population studied, cirrhosis of the liver (28 cases) ranked first followed by decompensated heart failure (8 cases), tuberculous peritonitis (5 cases) and malignant ascites (4 cases). The other causes were nephrotic syndrome (2 cases), splenic abscess (1 case), pancreatitis (1 case), spontaneous bacterial peritonitis (1 case) and hypothyroidism (1 case). The sensitivity and specificity of ascitic fluid total protein (AFTP) in the differentiation of different types of ascites are 83% and 63% respectively The sensitivity and specificity of serum ascites albumin gradient (SAAG) in the differentiation of different types of ascites are 95% and 92% respectively. The diagnostic accuracy of ascitic fluid total protein (AFTP) in the etiological diagnosis of ascites is 68%. The diagnostic accuracy of serum ascites albumin gradient (SAAG) in the etiological diagnosis of ascites is 94%. The serum ascites albumin gradient (SAAG) is superior to ascitic fluid total protein (AFTP) in the differential diagnosis of ascites and it is statistically significant. Conclusion: Thus Serum ascites albumin gradient (SAAG) is the single best test against ascitic fluid total protein (AFTP), in the differential diagnosis of ascites. The terms exudative and transudative can be replaced by high SAAG and low SAAG ascites.