Etiological and Biochemical Profile of Low SAAG Ascites: Insights from a Tertiary Care Center in Western Maharashtra
Rahil Arora, Santosh K. Singh, Shantanu Khanna, Pradeep K. Singh, Neel K. Issar, Balakrishnan Arivalagan, Kritika Dewan, Parrina Sehgal, Vani SinghBackground:
The serum-ascites albumin gradient (SAAG) is a key diagnostic marker in ascitic fluid analysis. While high SAAG ascites is often associated with portal hypertension, low SAAG ascites is primarily linked to peritoneal diseases such as tuberculosis, malignancy, pancreatitis, and nephrotic syndrome. This study aimed to analyze the etiological and biochemical characteristics of low SAAG ascites in patients admitted to a tertiary care hospital in Western Maharashtra.
Methods:
We conducted a combined prospective and retrospective study including patients with ascites between 2010 and 2025. Patients with SAAG <1.1 g/dL were identified and evaluated. Biochemical parameters such as serum albumin, ascitic albumin, ascitic LDH, and total leukocyte count (TLC) were measured. The etiologies of low SAAG ascites were classified based on clinical, laboratory, and imaging findings. Statistical analysis was performed using SPSS.
Results:
Tuberculosis was the most frequent cause of low SAAG ascites in patients <65 years (
Conclusion:
Tuberculosis remains the leading cause of low SAAG ascites in younger individuals, while malignancy predominates in the elderly. Biochemical markers such as ascitic LDH and TLC enhance diagnostic accuracy and should be integrated into the routine evaluation of low SAAG ascites to guide timely diagnosis and management.