Du L, et al. - In this prospective cohort study, researchers investigated the diagnostic performance of ascitic cholesterol in the differential diagnosis of ascites. For this investigation, they prospectively recruited consecutive patients with new-onset ascites. The relevant data from 629 patients with all forms of ascites were collected. Outcomes revealed that high ascitic cholesterol (≥45 mg/dL) has a high sensitivity for detecting non-portal hypertension (NPH)-related ascites. According to the findings, ascitic cholesterol is an excellent measure for NPH ascites detection and the identification of peritoneal lesions in mixed ascites. The diagnostic accuracy of ascitic cholesterol was 69% in the patients misdiagnosed based on serum-ascites albumin gradient (SAAG) classification. This simple and cost-effective parameter should thus be determined in clinical practice in all patients with new-onset ascites.