| Peer-Reviewed

A Determination of the Serum Ascitic Fluid Albumin Concentration Gradient in Children with Chronic Liver Disease and Nephrotic Syndrome

Received: 5 February 2020    Accepted: 23 April 2020    Published: 30 September 2020
Views:       Downloads:
Abstract

This prospective cross sectional study was carried out in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Dhaka Shishu Hospital, Dhaka for a period of one year and six months starting from July 2012 to December 2013. The main objective of the study was to determine the serum ascitic fluid albumin concentration gradient in children with chronic liver disease and nephrotic syndrome. A total of 55 children were studied. Among them, 31 children with chronic liver disease with ascites were designated as Group I and rest 24 nephrotic syndrome children with ascites were designated as group II. The mean age of the children was 8.3±3.6 years ranging from 1.0-15.0 years. The mean age of the male patient was 8.0±3.6 years and that of female patients was 9.3±3.5 years. No statistically significant mean age difference was found between male and female patients (p>0.05), although female patients had a bit higher mean age than male patients. The mean age of the group I patients was 9.2±3.7 years ranging from 1.0-14.0 years and group II patients was 7.2±3.2 ranging from 2.0 to 15.0 years and the mean age difference between two groups patients was statistically significant (p<0.05) indicated that patients with chronic liver disease had higher age than patients with nephrotic syndrome. Chronic liver diseases patients where liver biopsy could not be performed to ascertain the exact nature of the disease were labeled as unclassified chronic liver disease. The aetiology of chronic liver diseases of the group I patients. Out of 31 patients, highest percentage of patients were of unknown etiology 17 (54.9%) followed by hepatitis B virus 7 (22.6%) and Wilson’s disease 5 (16.1%). It was evident that 24 (77.4%) had serum bilirubin >1.2 mg/dl, serum ALT >40 IU/L was 25 (80.6%), prothrombin time more than 3 second than control 23 (74.2%) and serum albumin less than 3.5 mg/dl was 24 (77.4%). The mean serum albumin was 2.8±0.5 mg/dl in group I patients and 1.7±0.4 mg/dl in group II patients. The albumin in ascitic fluid was 1.2±0.4 mg/dl in group I patients and 0.9±0.3 mg/dl in group II patients. Similarly, serum-ascites albumin gradient was 1.6±0.5 in group I and 0.8±0.2 in group II. It was evident that mean serum albumin, ascetic albumin as well as serum-ascites albumin gradient was significantly higher among the group I patients compared to group II patients (p<0.001).

Published in American Journal of Pediatrics (Volume 6, Issue 4)
DOI 10.11648/j.ajp.20200604.11
Page(s) 386-391
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Paediatric, Albumin, Nephrotic, Biochemical

References
[1] Karim, A. S. M. B., Akhter, S., Karim, M. A. & Nazir, M. F. H. 1999, ‘A study of the clinical profile of chronic liver diseases in children’, DS (Child) HJ, vol. 15. No. 1 & 2, pp. 16-19.
[2] Lucas. A. & Elia, M. 1990, ‘The chronic liver diseases spectrum’, Medicine International, vol. 3, pp. 3460.
[3] Sherlock, S. & Dooley, J. 2002, ‘Hepatic cirrhosis’ in Diseases of the Liver and Biliary System, 11th end, Blackwell science, Oxford, pp. 365-380.
[4] Valeta, E. A., Loreti, S., Cipolli, M., Cazzola, G. & Zanolla, I. 1993, ‘Portal hypertension and esophageal varices in cystic fibrosis: unreliability of echo-doppler flowmetry’, Scand J. Gastroenterol, vol. 28, pp. 1042-1016.
[5] Runyon, B. A., Montano, A. A., Akriviadis, E. A., Antillon, M. R., Irving, M. A. & McHutchison, J. G. 1992, ’The serum-ascites albumin gradient in the differential diagnosis of ascites is superior to the exudate-transudate concept’, Ann Intern Med, vol. 117, pp. 215-220.
[6] Rector, W. G. & Reynolds, T. B. 1984, ’Superiority of serum-ascites albumin difference over the ascites total protein concentration in separation of transudative and exudative ascites’, Am J Med, vol. 77, pp. 83-85.
[7] Pare, P., Talbot, J. & Hoefs, J. C. 1983, ‘Serum-ascites albumin concentration gradient: a physiologic approach to the differential diagnosis of ascites’, Gastroenterology, vol. 85, pp. 240-244.
[8] Hoefs, J. C. 1983, ‘Serum protein concentration and portal pressure determine the ascitic fluid protein concentration in patients with chronic liver diseae’, Lab Clin Med, vol. 102, no. 2, pp. 260-273.
[9] Salam, K. M. A. 1989, ‘Aetiology of ascites in children’, FCPS (Paediatrics) Dissertation, BCPS, Dhaka.
[10] Runyon, B. A. 1993, ‘Ascites and spontaneous bacterial peritonitis’, in Gastrointestinal Disease: pathophysiology, diagnosis and management, vol. II. 5th edn, eds. M. H. Sleisenger &, J. S. Fordtran, W. B. Saunders Company, Philadelphia, pp. 1997-2003.
[11] Runyon, B. A. 1994, ‘Care of patients with ascites’, N Engl J Med, vol. 330, no. 5, pp. 337-342.
[12] Kajani, M. A., Yoo, Y. K., Alexander, J. A., Gavaler, J. S., Stauber, R. E., Dindzans, V. J. et al. 1990, ‘Serum-ascites albumin gradients in nonalcoholic liver disease’, Dig Dis Sci, vol. 35, no. 1, pp. 33-37.
[13] Torres, E., Barros, P. & Calmet, F. 1998, ‘Correlation between serum- ascites albumin concentration gradient and endoscopic parameters of portal hypertension’, Am J Gastroenterol, vol. 93, no. 11, pp. 2172-2178.
[14] Das, B. B., Purohit., A., Acharya, U. & Treskova, E. 2001, ‘Serum-Ascites Albumin Gradient: predictor of Esophageal Variecs with Ascites’, Indian J Pediatr, vol. 68, no. 6, pp. 511-514.
[15] Akriviadis, E. A., Kapnias, D., Hadjigavriel, M., Mitsiou, A. & Goulis, J. 1996, ‘Serum/ascites albumin gradient: its value as a rational approach to the differential diagnosis of ascites’, Scand J Gastroenterol, vol. 31, no. 8, pp. 814-817.
[16] Torres, E., Calmet, F. & Barros, P. 1996, ‘Endoscopic and clinical parameters in assessing the degree of portal hypertension; the value of serum ascites albumin gradient’, Rev Gastroenterol Peru, vol. no 1, pp. 20-26.
Cite This Article
  • APA Style

    Md. Zakaria, ASM Bazlul Karim, Mohammad Monir Hossain, Md. Wahiduzzaman Mazumder, Md. Mostafa Zaman, et al. (2020). A Determination of the Serum Ascitic Fluid Albumin Concentration Gradient in Children with Chronic Liver Disease and Nephrotic Syndrome. American Journal of Pediatrics, 6(4), 386-391. https://doi.org/10.11648/j.ajp.20200604.11

    Copy | Download

    ACS Style

    Md. Zakaria; ASM Bazlul Karim; Mohammad Monir Hossain; Md. Wahiduzzaman Mazumder; Md. Mostafa Zaman, et al. A Determination of the Serum Ascitic Fluid Albumin Concentration Gradient in Children with Chronic Liver Disease and Nephrotic Syndrome. Am. J. Pediatr. 2020, 6(4), 386-391. doi: 10.11648/j.ajp.20200604.11

    Copy | Download

    AMA Style

    Md. Zakaria, ASM Bazlul Karim, Mohammad Monir Hossain, Md. Wahiduzzaman Mazumder, Md. Mostafa Zaman, et al. A Determination of the Serum Ascitic Fluid Albumin Concentration Gradient in Children with Chronic Liver Disease and Nephrotic Syndrome. Am J Pediatr. 2020;6(4):386-391. doi: 10.11648/j.ajp.20200604.11

    Copy | Download

  • @article{10.11648/j.ajp.20200604.11,
      author = {Md. Zakaria and ASM Bazlul Karim and Mohammad Monir Hossain and Md. Wahiduzzaman Mazumder and Md. Mostafa Zaman and Nadira Parvin},
      title = {A Determination of the Serum Ascitic Fluid Albumin Concentration Gradient in Children with Chronic Liver Disease and Nephrotic Syndrome},
      journal = {American Journal of Pediatrics},
      volume = {6},
      number = {4},
      pages = {386-391},
      doi = {10.11648/j.ajp.20200604.11},
      url = {https://doi.org/10.11648/j.ajp.20200604.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20200604.11},
      abstract = {This prospective cross sectional study was carried out in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Dhaka Shishu Hospital, Dhaka for a period of one year and six months starting from July 2012 to December 2013. The main objective of the study was to determine the serum ascitic fluid albumin concentration gradient in children with chronic liver disease and nephrotic syndrome. A total of 55 children were studied. Among them, 31 children with chronic liver disease with ascites were designated as Group I and rest 24 nephrotic syndrome children with ascites were designated as group II. The mean age of the children was 8.3±3.6 years ranging from 1.0-15.0 years. The mean age of the male patient was 8.0±3.6 years and that of female patients was 9.3±3.5 years. No statistically significant mean age difference was found between male and female patients (p>0.05), although female patients had a bit higher mean age than male patients. The mean age of the group I patients was 9.2±3.7 years ranging from 1.0-14.0 years and group II patients was 7.2±3.2 ranging from 2.0 to 15.0 years and the mean age difference between two groups patients was statistically significant (p1.2 mg/dl, serum ALT >40 IU/L was 25 (80.6%), prothrombin time more than 3 second than control 23 (74.2%) and serum albumin less than 3.5 mg/dl was 24 (77.4%). The mean serum albumin was 2.8±0.5 mg/dl in group I patients and 1.7±0.4 mg/dl in group II patients. The albumin in ascitic fluid was 1.2±0.4 mg/dl in group I patients and 0.9±0.3 mg/dl in group II patients. Similarly, serum-ascites albumin gradient was 1.6±0.5 in group I and 0.8±0.2 in group II. It was evident that mean serum albumin, ascetic albumin as well as serum-ascites albumin gradient was significantly higher among the group I patients compared to group II patients (p<0.001).},
     year = {2020}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - A Determination of the Serum Ascitic Fluid Albumin Concentration Gradient in Children with Chronic Liver Disease and Nephrotic Syndrome
    AU  - Md. Zakaria
    AU  - ASM Bazlul Karim
    AU  - Mohammad Monir Hossain
    AU  - Md. Wahiduzzaman Mazumder
    AU  - Md. Mostafa Zaman
    AU  - Nadira Parvin
    Y1  - 2020/09/30
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ajp.20200604.11
    DO  - 10.11648/j.ajp.20200604.11
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 386
    EP  - 391
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20200604.11
    AB  - This prospective cross sectional study was carried out in the Department of Paediatrics, Bangabandhu Sheikh Mujib Medical University, Dhaka Medical College Hospital and Dhaka Shishu Hospital, Dhaka for a period of one year and six months starting from July 2012 to December 2013. The main objective of the study was to determine the serum ascitic fluid albumin concentration gradient in children with chronic liver disease and nephrotic syndrome. A total of 55 children were studied. Among them, 31 children with chronic liver disease with ascites were designated as Group I and rest 24 nephrotic syndrome children with ascites were designated as group II. The mean age of the children was 8.3±3.6 years ranging from 1.0-15.0 years. The mean age of the male patient was 8.0±3.6 years and that of female patients was 9.3±3.5 years. No statistically significant mean age difference was found between male and female patients (p>0.05), although female patients had a bit higher mean age than male patients. The mean age of the group I patients was 9.2±3.7 years ranging from 1.0-14.0 years and group II patients was 7.2±3.2 ranging from 2.0 to 15.0 years and the mean age difference between two groups patients was statistically significant (p1.2 mg/dl, serum ALT >40 IU/L was 25 (80.6%), prothrombin time more than 3 second than control 23 (74.2%) and serum albumin less than 3.5 mg/dl was 24 (77.4%). The mean serum albumin was 2.8±0.5 mg/dl in group I patients and 1.7±0.4 mg/dl in group II patients. The albumin in ascitic fluid was 1.2±0.4 mg/dl in group I patients and 0.9±0.3 mg/dl in group II patients. Similarly, serum-ascites albumin gradient was 1.6±0.5 in group I and 0.8±0.2 in group II. It was evident that mean serum albumin, ascetic albumin as well as serum-ascites albumin gradient was significantly higher among the group I patients compared to group II patients (p<0.001).
    VL  - 6
    IS  - 4
    ER  - 

    Copy | Download

Author Information
  • Depterment of Paediatrics, Sunamgong Sadar Hospital, Sunamgong, Sylhet, Bangladesh

  • Depterment of Paediatric Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

  • Depterment of Paediatric Neurology, Bangabandhu Sheik Mujib Medical University (OSD), Dhaka, Bangladesh

  • Depterment of Paediatric Gastroenterology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh

  • Depterment of Paediatrics, M Abdur Rahim Medical College (MARMC), Dinajpur, Bangladesh

  • Depterment of Pharmacology and Therapeutics, TMSS Medical College, Bogura, Bangladesh

  • Sections