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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).
Albumin is an acute negative phase respondent and not a reliable indicator of nutrition status. [10] Low albumin levels can also indicate chronic malnutrition from protein losing enteropathy. [3] This is often caused or exacerbated by ulcerative colitis, [11] but can also be seen in cardiac disease and systemic lupus erythematosus. [3]
In the largest study published to date, featuring over 12,000 data sets, Figge, Bellomo and Egi [18] demonstrated that the anion gap, when used to detect critical levels of lactate (greater than 4 mEq/L), exhibited a sensitivity of only 70.4%. In contrast, the albumin-corrected anion gap demonstrated a sensitivity of 93.0%.
This shows the levels of albumin and the different immunoglobulins The serum protein electrophoresis test measures the number of proteins in the serum part of a blood sample. The normal ranges to check for the serum globulin would be about 2.0 to 3.5 grams per deciliter then for the immunoglobulins A, M, and G have different ranges.
Albumin is a protein made specifically by the liver, and can be measured cheaply and easily. It is the main constituent of total protein (the remaining constituents are primarily globulins). Albumin levels are decreased in chronic liver disease, such as cirrhosis. It is also decreased in nephrotic syndrome, where it is lost through the urine.
Elevated protein (albumin, globulins) may theoretically increase the anion gap but high levels are not usually encountered clinically. Hypoalbuminaemia, which is frequently encountered clinically, will mask an anion gap. As a rule of thumb, a decrease in serum albumin by 1 G/L will decrease the anion gap by 0.25 mmol/L [citation needed]
“While there is a basic daily protein recommendation of 0.36 grams per pound of body weight, a goal of double that, 0.6 to 0.8 grams protein per pound, may be your protein ‘sweet spot’ if ...
An example of nutritional hypoproteinemia is Kwashiorkor, a type of protein energy malnutrition affecting young children. Malabsorption , often caused by celiac disease or inflammatory bowel disease Liver disease can also cause hypoproteinemia by decreasing synthesis of plasma proteins like albumin.