DOI: http://dx.doi.org/10.18203/2349-3933.ijam20180077

Correlation of serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension in chronic liver disease

Suresh I, Shiva Prasad Jagini

Abstract


Background: In many studies Serum ascitic albumin gradient (SAAG) was found to be an independent predictor of PHTN and EV especially in alcoholic cirrhosis. Objectives of this study was to study correlation of level of “Serum-Ascites Albumin Concentration Gradient” (SAAG) and complications of “Portal hypertension” (PHTN), manifested by “Esophageal Varices” (EV).

Methods: Present study was hospital based cross sectional study. The sample (100) was of patients with ascites. SAAG was measured in all subjects. EV was assessed by endoscopy in all. Data was analyzed using proportions and appropriate statistical tests.

Results: High SAAG value was seen in 79% of the patients. EV incidence was 84.5%. “child-pugh score” and size of the portal vein was found to be associated with EV. The incidence of EV among patients with high “SAAG value of 1.1 to 1.44 g/dl” was 50%. The size of the EV was found to be significantly associated with SAAG level.

Conclusions: Patients having ascites with EV were also having high levels of SAAG. Thus, we conclude that value of SAAG more than or equal to 1.2±0.05 g/dl can be used as a predictor of EV presence among ascites patients.


Keywords


Ascites, Cirrhosis of liver, SAAG

Full Text:

PDF

References


Minino AM, Smith BL. Deaths: preliminary data for 2000. Natl Vital Stat Rep. 2001;49:1-40.

World Life Expectancy. Available from: worldlifeexpectancy.com/world-rankings-total-deaths.

Diehl AM. Alcoholic liver disease. Med Clin North AM. 1989;73:815-30.

D’Amico G, Pagliaro L, Bosch J. The treatment of portal hypertension: a meta-analytic review. Hepatol. 1995;22:332-54.

D’Amico G, Luca A. Natural history. Clinical-haemodynamic correlations. Prediction of the risk of bleeding. Baillieres Clin Gastroenterol. 1997;11:243-56.

D’amico G, De Franchis R. Upper digestive bleeding in cirrhosis. Post-therapeutic outcome and prognostic indicators. Hepatol. 2003;38:599-612.

Graham D, Smith J. The course of patients after variceal hemorrhage. Gastroenterol. 1981;80:800-6.

De Franchis R. Updating consensus in portal hypertension: report of the Baveno III Consensus Workshop on definitions, methodology and therapeutic strategies in portal hypertension. J Hepatol. 2000;33:846-52.

De Franchis R. Evaluation and follow-up of patients with cirrhosis and oesophageal varices. J Hepatol 2003;38:361-3.

Runyon BA. Ascites and spontaneous bacterial peritonitis. In: Sleisenger MH, Fordtran JS, eds. Gastrointestinal diseases: pathophysiology diagnosis, management, Vol II. Philadelphia: W.B. Saunders Company. 1993;1977-2003.

Runyon BA, Montano AA, Akriviadis EA, et al. The serum-ascites albumin gradient in the differential diagnosis of ascites is superior to the exudate-transudate concept. Ann Intern Med. 1992;117:215-20.

Sherlock S. Ascites. In: Sherlock S, Dooley J, eds. Diseases of the liver and biliary system, ninth edition. Oxford: Blackwell Scientific Publications. 1993:114-31.

Graham D, Smith J. The course of patients after variceal hemorrhage. Gastroenterol. 1981;80:800.

Madhotra R, Mulcahy HE, Willner I. Prediction of esophageal varices in patients with cirrhosis. J Clin Gastroenterol. 2002;34:81-5.

Zaman A, Becker T, Lopidus J. Risk factors for the presence of varices in cirrhotic patients without a history of variceal hemorrhage. Arch Int Med. 2001;161:2564-70.

D’Amico G, Morabito A. Non invasive markers of esophageal varices: Another round, not the last. Hepatol. 2004;39(1):30-4.

Torres E, Calme F, Herrera B. Echographic parameters in the evaluation of the degree of portal hypertension. Rev Gastroenterol. 1996;16(2):125-32.

Gurubacharya DL, Mathura KC, Karki DB. Correlation between serum-ascites albumin concentration gradient and endoscopic parameters of portal hypertension. Kathmandu University Medic J. 2005;3(12):327-33.

Kajani MA, Yoo YK, Alexandr JA. Serum-ascites albumin gradients in non-alcoholic liver disease. Digestive Disease Science. 1990;35(1):33-7.

Dittrich S, Yordi LM, de Mattos AA. The value of serum-ascites albumin gradient for the determination of portal hypertension in the diagnosis of ascites. Hepatogastroenterol. 2001;48(37):166-8.

Demyrel U, Karincaoglu U, Harpttuoqlu M et al. Two findings of portal hypertension: Evaluation of correlation between serum-ascites albumin concentration gradient and esophageal varices in non alcoholic cirrhosis. Turkish J Gastroenterol. 2003;14(4):219-22.