paracentesis
- SAAG > 1.1: portal HTN
- TP > 2.5: cardiac, heart failure, budd chiari
- TP < 2.5: cirrhotic
- if TP < 1.5: less complement, less immunity, assume SBP
- SAAG < 1.1: nephrotic syndrome
- SBP: signs of renal dysfunction, bad systemic function (bili > 3, Child pugh > 9)
- portal vein => (1) hepatic vein => heart
- sinusoids, protein from heart. Pressure pushes out protein, so higher protein
- in cirrhosis, fibrosis prevents outflow, so lower total protein