View source for Template:Diagnosis of SBP

===Diagnosis of [[SBP]] via [[Ascitic Fluid Analysis]]===
====Standard Evaluation====
*Paracentesis results supporting a diagnosis of SBP:
**Total WBC >500
**Absolute neutrophil count (PMNs) > 250
**Bacteria on [[gram stain]] (single type)
**SAAG > 1.1
***Diagnostic of portal hypertension with 97% accuracy<ref>Runyon BA, Montano AA, Akriviadis EA, et al. The serum-ascites albumin gradient is superior to the exudate-transudate concept in the differential diagnosis of ascites. Ann Intern Med 1992; 117:215.</ref>
***SBP rarely develops in patients without portal hypertension
**Protein < 1, Glucose > 50 (otherwise concern for secondary bacterial peritonitis)

''For bloody tap, subtract 1 WBC for every 250 RBC''

====If on Peritoneal Dialysis (CAPD)====
[[SBP]] if:
*>100 total WBCs OR >50% neutrophils

====If on Nightly APD====
[[SBP]] if:
* >50% neutrophils
* Amylase (>100 suggestive of intra-abdominal process)