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 Ascites.