What is saag and how is it calculated?
SAAG is actually the difference in concentration of albumin (a protein) in the serum (plasma without clotting proteins) and the albumin in the ascitic fluid, both obtained on the same day. The formula to calculate SAAG is as follows: Why is a Serum Ascites Albumin Gradient (SAAG) test performed?
What is the SAAG test for ascites?
The SAAG may be a better discriminant than the older method of classifying ascites fluid as a transudate versus exudate. The formula is as follows: SAAG = ( serum albumin) − (albumin level of ascitic fluid).
What does a low Saag mean?
SAAG = (Serum albumin) – (Ascitic fluid albumin) A high SAAG (>1.1g/dL) suggests the ascitic fluid is a transudate. A low SAAG (<1.1g/dL) suggests the ascitic fluid is an exudate.
What is saag in cirrhosis?
When this gradient, or Serum-Ascites Albumin Gradient (SAAG), is more than 1.1 g/dL, portal hypertension, as from cirrhosis, is generally the cause suggesting a nonperitoneal cause of ascites. When the SAAG is <1.1 g/dL, it means the ascitic fluid albumin level is high.
What does a SAAG score mean?
The SAAG is a physiological clinical diagnostic tool for the evaluation of ascites. An increased SAAG (> 1.1 gm/dL) value indicates the presence of portal hypertension, which is detected by observing portal hypertensive changes in the upper gastrointestinal tract.
What is the normal SAAG?
Under normal circumstances the SAAG is < 1.1 because serum oncotic pressure (pulling fluid back into circulation) is exactly counterbalanced by the serum hydrostatic pressure (which pushes fluid out of the circulatory system).
What does a low SAAG mean?
A low gradient (SAAG < 1.1 g/dL) indicates nonportal hypertension and suggests a peritoneal cause of ascites. Such conditions may include the following: Primary peritoneal mesothelioma. Secondary peritoneal carcinomatosis.
What does SAAG less than 1.1 mean?
A SAAG less than 1.1 g/dL suggests the cause of ascites is not related to portal hypertension. However, the presence of low SAAG in the clinical context of suspected cirrhosis should be repeated because up to 3.3% of patients with portal hypertension may have SAAG less than 1.1 g/dL. 7.
What level of albumin causes ascites?
It was found that plasma albumin levels less than 3 g/l were almost constantly associated with the presence of ascites, which did not develop with plasma levels greater than 4 g/l [11].
Can SAAG be negative?
Diagnostic accuracy, Sensitivity, Specificity, Positive predictive value (PPV) and Negative predictive value (NPV) of SAAG were 96%, 97%, 95%, 98.6%, and 90% respectively, whereas those of AFTP were 56%, 53%,70%, 86%, and 29% respectively.
Why is SAAG high in cardiac ascites?
A SAAG level of 1.1 g/dL or greater indicates that ascites is due to portal hypertension, the pathologic increase of pressure in the portal venous system (97.0% sensitivity and 90.2% specificity). In this context, an ascites protein level of 2.5 g/dL or greater suggests accumulation is due to heart failure.
How do you read SAAG?
A high SAAG (>1.1g/dL) suggests the ascitic fluid is a transudate. A low SAAG (<1.1g/dL) suggests the ascitic fluid is an exudate....Causes of a low SAAG (i.e. exudate) include:Malignancy.Infection.Pancreatitis.Nephrotic syndrome.
Can low albumin cause ascites?
A decrease in oncotic pressure due to a low albumin level allows fluid to leak out from the interstitial spaces into the peritoneal cavity, producing ascites.
Why is albumin given in ascites?
Albumin infusions have been used in the management of patients with cirrhosis and ascites with two main objectives: (1) to reduce the formation of ascites and oedema by increasing microvascular oncotic pressure; and (2) to improve circulatory and renal function by expanding total blood volume.
What causes ascites fluid?
Ascites results from high pressure in the blood vessels of the liver (portal hypertension) and low levels of a protein called albumin. Diseases that can cause severe liver damage can lead to ascites.
What is exudative ascites?
Exudative ascites E xudates fluid is from the inflamed and tumor laden peritoneal surface hence it is high in protein suggestive of Peritonitis or Malignant ascites. Common conditions that could result in this type of ascites include malignancy, tuberculosis infection, and inflammatory conditions like pancreatitis.
What is the normal range of albumin?
Normal Results The normal range is 3.4 to 5.4 g/dL (34 to 54 g/L). Normal value ranges may vary slightly among different laboratories. Some labs use different measurements or test different samples.
How do you count SAAG?
Calculation of SAAG is performed by measuring the serum albumin and ascitic fluid albumin concentrations simultaneously and then subtracting the ascitic fluid albumin from the serum albumin. A SAAG of >1.1 g/dL is 97% accurate in detecting portal hypertension (Fig.
How do you read SAAG?
A high SAAG (>1.1g/dL) suggests the ascitic fluid is a transudate. A low SAAG (<1.1g/dL) suggests the ascitic fluid is an exudate....Causes of a low SAAG (i.e. exudate) include:Malignancy.Infection.Pancreatitis.Nephrotic syndrome.
What is the significance of serum ascites albumin gradient?
Defines presence of portal hypertension in patients with ascites. Patients with known liver disease and ascites in whom portal hypertension status is unknown. The serum ascites albumin gradient (SAAG) can determine which patients with liver disease have portal hypertension.
What does low SAAG mean?
A low SAAG indicates nonportal hypertension suggesting a peritoneal cause of ascites.
What is the SAAG of exudate acites?
In an exudate acites or high protein ascites, the SAAG is less than 11 g/L (1.1 g/dL) with a high protein concentration of more than 2.5 g/dL. This is a finding in infection especially tuberculosis, cancers and pancreatic ascites.
What is the serum ascites albumin gradient?
The serum ascites albumin gradient ( SAAG) is a formula that is used to assist in determining the cause of ascites. Ascites is an abnormal accumulation of fluid within the (peritoneal) cavity. One of the most common liver diseases is caused by cirrhosis of the liver but it can also be caused by other diseases.
What is the SAAG for ascites?
Ascites total protein content and serum-ascites albumin gradient (SAAG) are two inexpensive measurements that, taken together, are most useful in determining the cause of ascites and therefore in guiding the workup of patients with ascites.
What is pigtail catheter?
Pigtail catheters relieve distention immediately but they are occasionally complicated by catheter-related sepsis, hypotension, and occlusion. 29,30 Tunneled catheters (e.g., PleuRx) are associated with fewer infectious complications than nontunneled catheters and are approved for the management of malignant ascites.
What is serum ascites albumin gradient?
Serum-ascites albumin gradient (SAAG) is more useful than the total protein concentration of ascitic fluid in the classification of ascites. This gradient is physiologically based on oncotic-hydrostatic balance and is related directly to portal pressure. The serum-ascites albumin gradient is calculated by subtracting the albumin concentration of ascitic fluid from the albumin concentration of serum obtained on the same day:
What is the SAAG?
The serum-ascites albumin gradient or gap ( SAAG) is a calculation used in medicine to help determine the cause of ascites. The SAAG may be a better discriminant than the older method of classifying ascites fluid as a transudate versus exudate.
Why does the SAAG increase?
The SAAG subsequently increases because there is more free fluid leaving the circulation , concentrating the serum albumin.
What is the SAAG test?
There are a number of different health conditions that can adversely affect the overall wellness and quality of life of patients. Some of them can be more life-threatening than others while some may be less risky especially when they are immediately treated or addressed. Fortunately, the advancement in technologies and the improved scientific research in the recent century or so resulted in some pretty accurate medical tests that can provide a clear picture of what illness individuals or patients are suffering from. One such test is known as the SAAG test or the Serum Ascites Albumin Gradient. But what is this for and how is it used? In this article let us first look at what Ascites is and how SAAG can be used to determine the cause of the said condition.
What does low gradient mean in a SAAG?
On the other hand, SAAG Ascites that are considered low gradient (<11 g/L, <1.1 g/L) may indicate that the ascites is caused by other conditions not associated with portal pressure that is increased. These include pulmonary infarcts, peritoneal cancers, serositis, infections, pancreatitis, and tuberculosis.
Where does Serum-Ascites Albumin Gradient (SAAG) come in?
SAAG or Serum-Ascites Albumin Gradient (SAAG) is utilized in the field of medicine to aid in determining what caused ascites patients. This method has been observed to a better method to identify which type of ascites fluid is present and identifying ascites as either exudate or transudate. The formula for SAAG is serum albumin minus albumin level of ascitic fluid.
What does a high SAAG mean?
So how is SAAG interpreted? If the SAAG indicates a high gradient (>11g/L, >1.1 g/L) means that there is portal hypertension which can indicate a condition that may be liver or non-liver related and with an accuracy of around 97%. This is mainly due to the hydrostatic pressure of the hepatic portal system’s blood vessels. This can lead to the peritoneal cavity being filled with water but makes proteins like albumin getting left behind in the vasculature. Some of the possible causes of SAAG Ascites that are increased (>11g/L, >1.1 g/L) include idiopathic portal fibrosis, portal vein thrombosis, Budd-Chiari Syndrome, heart failure, and liver cirrhosis.
How to diagnose ascites?
How ascites are diagnosed. Ascites diagnosis will require a number of steps but the first thing to do is to check the abdomen for any swelling. The doctor may then use other methods of testing or imaging technology to identify the ascites. Some of these tests include angiography, laparoscopy, blood tests, MRI, CT Scan, and ultrasound.
What is the SAAG?
The serum ascitic albumin gradient (SAAG) indirectly measures portal pressure and can be used to determine if ascites is due to portal hypertension.
What does a high SAAG mean?
A high SAAG (>1.1g/dL) suggests the ascitic fluid is a transudate.
What is an ascitic fluid sample?
A sample of fluid is typically obtained using a needle and syringe (known as an “ascitic tap” or “paracentesis”) and sent for analysis.
What is Saag in India?
They also contain iron, magnesium, and calcium. In India, saag is not just cooked by itself but often combined with great success with all kinds of meat, such as go at, lamb or chicken, as well as fish and vegetarian ingredients.
What is Saag in food?
Simply put, the word saag refers to common leafy green vegetables found in the Indian subcontinent (India, Pakistan, Nepal and so forth). When people refer to saag, they do so most often while discussing vegetables such as spinach, fenugreek, mustard greens, collard greens, basella, and dill.
What are some good side dishes to serve with saag?
They go really well with bread like chapatis (a flatbread also known as roti) and naans (leavened flatbread baked in a tandoor or oven). Daals (lentils) are the perfect side dish to order with a saag entree.
Where is Saag most popular?
Saag dishes are said to be most popular in the Punjab region of India as well as in the Northern India regions of Uttar Pradesh and Haryana. It is also frequently served in Nepal.
What spices are used in Saag?
Alternatively, they may be cooked and creamed. Common spices used in saag dishes include cinnamon, cloves, ginger, chili, garlic, coriander, and cumin, among several others. These spices have health benefits such as improving blood circulation. They may even help to ward off infections.
What does a SAAG of 1.1 mean?
A SAAG above 1.1 g/dL (grams per decilitre) is an indication of portal hypertension and suggests non-peritoneal causes of ascites, such as:
How is a Serum Ascites Albumin Gradient (SAAG) test performed?
Your healthcare practitioner may order a blood test and ascitic fluid sample collection on the same day to calculate the SAAG. The blood sample will be collected from a vein in your arm.
How do you prepare for a Serum Ascites Albumin Gradient (SAAG) test?
On the day of the test, wear loose clothing and do not take diuretics (water pills), such as spi ronolactone and furos emide. Tell your doctor if you are taking any medicines.
What is serum albumin gradient?
Serum Ascites Albumin Gradient is a useful tool to determine the cause of ascites when it is associated with a liver condition.
Is a clinically correlated diagnosis a substitute for medical advice?
The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.
