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Diagnosing ascites: Value of ascitic fluid total protein, albumin, cholesterol, their ratios, serum‐ascites albumin and cholesterol gradient
Author(s) -
GUPTA R.,
MISRA S. P.,
DWIVEDI M.,
MISRA V.,
KUMAR S.,
GUPTA S. C.
Publication year - 1995
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/j.1440-1746.1995.tb01096.x
Subject(s) - ascites , medicine , albumin , ascitic fluid , cholesterol , serum albumin , gastroenterology , endocrinology
Ascitic fluid total protein, albumin, cholesterol, their ascites/serum ratios, serum‐ascites albumin and cholesterol gradients were measured for their ability to differentiate cirrhotic, malignant and tuberculous ascites in 76 patients. The mean ± s.d. ascitic fluid total protein, albumin, cholesterol, their respective ascitic fluid/serum ratios in cirrhotic ascites were lower than malignant and tuberculous groups ( P < 0.001 for each). The difference between malignant and tuberculous groups was significant for ascitic fluid/serum total protein ( P < 0.05) and ascitic fluid/serum albumin ( P < 0.01) only. Mean serum‐ascites albumin gradient in cirrhotics was higher than in the malignant and tuberculous groups ( P < 0.001 for each). The difference between malignant and tuberculous groups was significant ( P < 0.01). Mean ± s.d. serum‐ascites cholesterol gradient in cirrhotics was higher than that in malignant and tuberculous groups ( P < 0.001 for each). The difference between malignant and tuberculous groups was also significant ( P < 0.01). Both serum/ascitic fluid total protein less than 0.5 and ascitic fluid cholesterol less than 55 mg/dL had 94% diagnostic accuracy for differentiating cirrhotic from malignant and tuberculous ascites. Serum ascitic fluid albumin gradient greater than 1.1 g/dL, ascitic fluid/serum albumin less than 0.65 and ascitic fluid albumin less than 2 g/dL had diagnostic accuracy of 92, 92 and 91%, respectively. Ascitic fluid total protein had diagnostic accuracy of 88%. None of the tests was able to differentiate between malignant and tuberculous ascites. Measurement of ascitic fluid cholesterol concentration is a simple method of differentiating cirrhotic from non‐cirrhotic ascites.