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The serum-ascites albumin gradient or gap (SAAG) is a calculation used in medicine to help determine the cause of ascites. [1] The SAAG may be a better discriminant than the older method of classifying ascites fluid as a transudate versus exudate. [2] The formula is as follows: SAAG = (serum albumin) − (albumin level of ascitic fluid).
MDCalc was founded by two emergency physicians, Graham Walker, MD, and Joseph Habboushe, MD, MBA, [5] and provides over 500 medical calculators and other clinical decision-support tools. [6] The MDCalc.com website was launched in 2005. [5] In 2016, MDCalc launched an iOS app, [7] followed by an Android app in 2017. [8]
The reference range for total protein is typically 60-80g/L. (It is also sometimes reported as "6.0-8.0g/dl"), [2] but this may vary depending on the method of analysis. Concentrations below the reference range usually reflect low albumin concentration, for instance in liver disease or acute infection.
The albumin concentration is in g/dL. These MDRD equations are to be used only if the laboratory has NOT calibrated its serum creatinine measurements to isotope dilution mass spectrometry (IDMS). When IDMS-calibrated serum creatinine is used (which is about 6% lower), the above equations should be multiplied by 175/186 or by 0.94086.
For the adult male, the normal range is 0.6 to 1.2 mg/dl, or 53 to 106 μmol/L by the kinetic or enzymatic method, and 0.8 to 1.5 mg/dl, or 70 to 133 μmol/L by the older manual Jaffé reaction. For the adult female, with her generally lower muscle mass, the normal range is 0.5 to 1.1 mg/dl, or 44 to 97 μmol/L by the enzymatic method.
The reference range for albumin concentrations in serum is approximately 35–50 g/L (3.5–5.0 g/dL). [5] It has a serum half-life of approximately 21 days. [6] It has a molecular mass of 66.5 kDa. The gene for albumin is located on chromosome 4 in locus 4q13.3 and mutations in this gene can result in anomalous proteins.
This is termed the albumin/creatinine ratio (ACR) [10] and microalbuminuria is defined as ACR ≥3.5 mg/mmol (female) or ≥2.5 mg/mmol (male), [11] or with both substances measured by mass, as an ACR between 30 and 300 μg albumin/mg creatinine. [12] For the diagnosis of microalbuminuria, care must be taken when collecting sample for the urine ...
Proteinuria is defined as a protein/creatinine ratio greater than 45 mg/mmol (which is equivalent to albumin/creatinine ratio of greater than 30 mg/mmol or approximately 300 mg/g) with very high levels of proteinuria having a ratio greater than 100 mg/mmol. [23]