Portal venous pressure and the serum-ascites albumin concentration gradient

CLINICAL ISSUE Other investigators have found the serumascites albumin concentration gradient to be 1.1 g/dL or greater in the presence of portal hypertension and less than that in its absence.

OBJECTIVE To determine if any correlation exists between the serum-ascites albumin concentration gradient (which reflects the net serum oncotic pressure) and the portal venous pressure.

METHODS The study group comprised 15 patients who had alcoholic cirrhosis. The portal venous pressure was calculated as the difference between the measured hepatic venous wedge and inferior vena cava pressures and was expressed as the hepatic venous pressure gradient.

SUMMARY All patients had portal hypertension; the mean hepatic venous pressure gradient was 14.81 ± 6.91 (SD) mm Hg. Fourteen of the 15 patients had a serum-ascites albumin concentration gradient of at least 1.1 g/dL; the mean value was 2.168 ± .709 g/dL. No correlation was found between these variables (r = .0459, P > .05).

CONCLUSIONS Although the serum-ascites albumin concentration gradient is a sensitive indicator of portal hypertension in patients with alcoholic cirrhosis, it does not reflect the portal venous pressure.