The hepatorenal syndrome (HRS) is the development of renal failure in-patients with severe liver disease (acute or chronic) in the absence of any other identifiable cause of renal pathology. The hepatorenal syndrome occurs typically in a patient with advanced liver cirrhosis with jaundice and ascites. The urine output is low with a low urinary sodium concentration. This study was carried out on 41 hepatic patients randomly selected from those admitted to the Tropical and Internal Medicine department in Kasr El-Aini Hospital. They were 14 male patients and 27 female patients with age ranging from 15 to 76 years. All the patients were suffering from chronic endemic liver disease of different severity. They had no clinical or laboratory evidence of diabetes mellitus, hypertension or renal diseases. Multiple clinical and laboratory parameters were assessed at the time of the duplex Doppler ultrasound examination. The goal of our study was to correlate the resistive index of the renal vessels with urinary sodium concentrations in different stages of non-azotemic patients with chronic liver disease. Early identification of changes in these parameters in patients with established liver disease who are at particular risk for the development of the hepatorenal syndrome may be beneficial because clinical management may be modified