Ascites in Ibadan, Nigeria – usefulness of albumin gradient in its etiologic diagnosis

In a 2-year prospective study, ninety adult patients with ascites at the University College Hospital Ibadan were evaluated clinically in addition to a diagnostic work‑up protocol. Of these, 40 (44%) had liver cirrhosis, 21 (23%) had tuberculous peritonitis, 20 (22%) had malignant ascites, 5 (6%) had heart diseases and 4 (5%) had nephrotic syndrome. Albumin gradient was compared with the usual parameters of ascitic fluid analysis in the differential diagnosis of ascites. We showed that the ascitic fluid total protein concentration, the ascitic fluid/serum total protein, the ascitic fluid lactic dehydrogenase, and the ascitic fluid/serum lactic dehydrogenase were lower in the patients with liver cirrhosis than in the patients with tuberculous peritonitis (p180 IU/L (77%), ascitic fluid total protein >3.0 g/dL (73%), ascitic fluid to serum lactic dehydrogenase ratio >0.6 (70%) and ascitic fluid to serum total protein ratio >0.5 (63%)