الفهرس 
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Abstract
HRS carries the worst prognosis of all the complications of liver cirrhosis.
Cirrhosis is a chronic to the normal liver tissue that prevents this important organ from working as it should.
If the damage is not stopped, the liver gradually loses its ability to carry out its normal functions. This is called liver failure, sometimes referred to as end-stage liver disease. Cirrhosis of the liver is disease found all over the world, affecting all races, age groups and both sexes. The clinical presentation of liver cirrhosis is often asymptomatic until complications appear.
The diagnosis of HRS is currently made using criteria to exclude other causes of renal failure that can occur in cirrhosis.
MELD score was originally used to determine the priority of organ transplant recipients but it was later modified to estimate the severity of end-stage liver disease in pretransplant patient, i.e. increased MELD score was closely associated with increased mortality. Recently the MELD scoring system has been recognized as an ideal approach for evaluating end-stage liver disease.
NGAL was recently identified by microarray analysis as one of the earliest and most robustly induced genes and proteins in the kidney after ischemic or nephrotoxic injury in both animals and humans, and NGAL proteins was easily detected in the blood and urine soon after acute kidney injury (AKI).
The main aim of this study was to evaluate Serum Neutrophil Gelatinase Associated Lipocalin in patients with hepatorenal syndrome in comparison to patients with liver cirrhosis and patients with liver cirrhosis and ascitis.
45 patients were recruited for this study and were classified into 3 groups:
Group I: 15 patients with liver cirrhosis.
Group II: 15patient with liver cirrhosis and ascites.
Group III: 15 patients with hepatorenal syndrome.
The study showed highly significant s .NGAL among patients with HRS and patients with liver cirrhosis and ascitis as compared to patients with liver cirrhosis.
Serum NGAL shows highly significant positive correlation with serum creatinine regard correlation studies between serum NGAL and laboratory parameters, we found significant positive correlation between serum NGAL and the following parameters: creat. (r=0.593, p=0.001), Bun (r=0.572, p=0.001).
On the other hand we found significant negative correlation between serum NGAL and the following parameters: UNa (r=-0.572, p=0.001), total protein (r= - 0.771, p=0.001).
No significant correlation was found between serum NGAL and the following parameters: Age, ALT, T.Bili, D.Bili, S.albumin, PT, INR, S.Na, S.K, Ascitic fluid cells (WBCs, T.Pro, Glucose, LDH, Alb), CBC (WBC, HB, PLT), AFP, FBS.