Background: Hepatorenal syndrome [HRS] is a common complication that occurs in people with decompensated cirrhosis and may result in a higher chance of death if not addressed. HRS is a prevalent complication observed in individuals with decompensated cirrhosis which leads to an elevated risk of mortality if left untreated.
The aim of the work: To assess the ability of urinary interleukin-18 [IL-18] to be used as potential biomarker for HRS in patients with decompensated liver cirrhosis.
 Patients and Methods: 120 hospitalized patients with decompensated liver cirrhosis, either with or without HRS were participated in the study. Two groups of patients were identified: 60 patients who had HRS and 60 patients who did not have HRS.
Results: Group I exhibited a considerably elevated IL-18 level compared to Group II [57.7±19.7 vs. 19.1±7.93 ng/ mL] [P = 0.001]. At the cutoff point of IL-18, more than 30.1[ng/ mL], it had 96% sensitivity and 90% specificity in detecting HRS patients.
Conclusion: Urinary IL-18 may prove to be a valuable biomarker for identifying HRS in patients with decompensated liver cirrhosis, providing valuable insights for diagnosis and management in this clinical setting.