Jaques DA, et al. - In this prospective study involving 105 hospitalized patients with decompensated cirrhosis, researchers assessed the utility of several biomarkers to determine the presence of acute kidney injury (AKI), its etiology, its severity, and a composite clinical outcome at 30 days. They recorded serum creatinine (SCr), Cystatin C (CystC), NGAL and urinary NGAL, KIM-1, protein, albumin, and sodium measures on three separate occasions. AKI was present in 55 patients. SCr, CystC, NGAL (plasma and urinary), urinary sodium, and renal resistive index (RRI) at inclusion were found to be independently related to the presence of AKI. The subsequent development of AKI was predicted by SCr, CystC, and plasma NGAL. All biomarkers paralleled the severity of AKI. The development of the composite clinical outcome was predicted by SCr, CystC, and plasma NGAL, and their performance was the same as that of the MELD score. Overall, early evaluation of renal biomarkers in patients with decompensated cirrhosis may offer valuable information on AKI etiology and improve AKI diagnosis and prognosis.