الفهرس 
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Abstract
Renal dysfunction is a well-established adverse predictor associated with increased mortality in cirrhosis, particularly after acute complications, such as variceal bleeding and sepsis and also after liver transplantation (LT). Patients with decompensated cirrhosis who develop hepatorenal syndrome (HRS) have very high mortality (particularly for HRS type I because the median survival without specific therapy is only 2 weeks). The prognostic impact of renal function is reflected by the inclusion of serum creatinine (Cr) in the model for end-stage liver disease (MELD) score, which predicts the likelihood of death within 3 months and is used for prioritization of recipients (sickest first) in the United States. Although Cr is a routine laboratory test and widely accepted as a measure of renal function, it is only an indirect marker of renal function (ie, of glomerular filtration rate [GFR]), because it is influenced by several extrarenal factors such as total muscle mass, ethnicity, and sex . Because renal dysfunction is so important prognostically, both before and after LT, and because of its inclusion in MELD score, the accurate assessment of renal function in cirrhosis has become even more important and necessary than hitherto believed. Ascites is the most common complication of decompensated cirrhosis and urinary sodium excretion is a useful tool to evaluate and manage this group of patients. Patients with decompensated cirrhosis have reduced 24-hour urinary sodium excretion (24UNa) and those with refractory ascites with or without HRS are characterized by no weight loss with 24UNa less than 78 mmol/d despite high-dose diuretic treatment. However, 24-hour collection of urine for determination of 24UNa is cumbersome. In our previous study, we showed that 24UNa was correlated significantly with a random urine spot sodium to potassium ratio (UNa/K). The study is aimed to investigate of the UNa /k ratio and its correlation with the presence of renal dysfunction in patients with decompensoted cirrhosis and ascites. The present study was carried out at at internal medicine department of Tanta university hospital and El-Menshawy general hospital in the period of 6 months from September 2019 to the end of Gun 2020. 100 consecutive patients with decompensated cirrhosis and ascites. The main results of the study revealed that: • Mean UNa was 38.19 ±11.87 with range of 4.0 –84.0 and mean Uk was 64.62 ±21.65 with range of 21.0 –99.0, uNa/K ratio was <1 in 79% of cases and >1 in 21%. • There is high significant negative correlation between uNa/K ratio and creatinine, there is significant negative correlation between uNa/K ratio and urea, also there is significant positive correlation between uNa/K ratio and GFR, while there is no significant correlation between uNa/K ratio and sUA . Based on our results we recommend for further studies n larger patients and longer period of follow up to emphasize our conclusion.