SAAG Calculator

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g/dL is the conventional unit in North America. g/L is used in many European and UK labs (1 g/dL = 10 g/L).
Albumin concentration measured in blood serum, obtained on the same day as the ascitic fluid sample.
g/dL
Albumin concentration measured in ascitic fluid obtained by paracentesis on the same day as the serum sample.
g/dL
SAAGPortal hypertension
1.7g/dL

Serum albumin minus ascitic fluid albumin

SAAG (g/L)17g/L
Clinical categoryHigh SAAG - portal hypertension likely
1.7 g/dL
Non-portal<1.1Portal HTN1.1-2Marked portal HTN2+

SAAG is 1.70 g/dL - portal hypertension is likely.

  • A SAAG above 1.1 g/dL identifies portal hypertension as the mechanism of ascites with approximately 97% accuracy.
  • Common portal hypertensive causes include cirrhosis, alcoholic hepatitis, cardiac ascites, Budd-Chiari syndrome (early), and portal vein thrombosis.
  • Ascitic fluid total protein (AFTP) can help narrow the cause further: AFTP below 2.5 g/dL with high SAAG strongly suggests cirrhosis, while AFTP above 2.5 g/dL suggests cardiac or Budd-Chiari origin.
  • Both albumin samples must be obtained on the same day - even a 24-hour gap can reduce accuracy because albumin levels fluctuate.

Next stepInitiate sodium restriction (less than 2 g/day) and consider diuretics. Evaluate for the specific cause with liver imaging, echocardiography if cardiac ascites is suspected, and hepatic vein Doppler for Budd-Chiari.

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