Most of these studies measured biomarkers after a specific insult (cardiopulmonary bypass8 or liver transplantation9, 10) with relatively few undertaking prospective evaluation in the 48 h prior to onset of AKI.11 Two recent studies examined urinary neutrophil gelatinase-associated lipocalin (NGAL) levels in patients with cirrhosis with and without ascites and AKI or HRS and evaluated its role as a predictor of mortality.12, 13 Urinary NGAL concentrations were significantly higher in those with impaired kidney function, urinary tract infections, CKD and HRS. This evidence concerns the gene LCN2 and acute kidney injury.