In the prospective study by Pockros and colleagues,19 a response to diuretics was seen in patients with ascites due to massive hepatic metastases who had a serum-ascites albumin gradient >1.1 g/dL (congruent to the serum-ascites albumin gradient of patients with benign ascites due to liver cirrhosis), whereas patients with ascites caused by peritoneal carcinomatosis or chylous malignant ascites who had no portal hypertension and a serum-ascites albumin gradient <1.1 g/dL did not respond to diuretics. Here, ALB is linked to portal hypertension.