Abstract: Objective The aim of this study was to explore the changes and clinical implications of urine microalbumin (U-mAl), peripheral blood neutrophil/lymphocyte ratio (NLR) and serum neutrophil gelatinase-associated lipocalin (NGAL) level in patients with cirrhosis and complicated hepatorenal syndrome (HRS). Methods 43 patients with cirrhosis and complicated HRS, and 43 patients with decompensated cirrhosis were admitted to our hospital between January 2020 and January 2022, and urine U-mAl level was detected by full-automatic specific protein analyzer. The peripheral blood lymphocyte count and neutrophil count were detected by full-automatic blood cell analyzer, and NLR was calculated. Serum NGAL level was detected by ELISA. The correlation was analyzed by Pearson’ and the diagnostic efficacy was evaluated by receiver operating characteristic (ROC) curves. Results Urine U-mAl level, the NLR and serum NGAL level in patients with cirrhosis and HRS were(25.7±5.3)mg/24 h,(3.8±0.8) and (31.8±6.5) ng/mL, significantly higher than [(18.9±3.4)mg/24 h, (3.1±0.6) and (26.1±4.8) ng/mL, respectively, P＜0.05] in patients with decompensated cirrhosis; urine U-mAl level was positively correlated to NLR or serum NGAL level (r=0.470, r=0.476, both P<0.001), and the NLR was also positively correlated to serum NGAL level (r=0.752, P<0.001) in patients with cirrhosis and HRS; the AUCs were 0.741, 0.733 and 0.734 (P＞0.05), as urine U-mAl equal to 25.0 mg/24 h, the NLR equal to 3.5 and serum NGAL level equal to 29.2 ng/mL were set as the cut-off-value, in predicting HRS in patients with cirrhosis, while the AUC was 0.870, with the sensitivity of 0.973 and the specificity of 0.767 when the three parameters was combined to predict (Z=3.047, Z=3.039, and Z=2.806, all P<0.01). Conclusion The detection of urine U-mAl level, peripheral blood NLR and serum NGAL level might be an easy way to predict the occurrence of HRS in patients decompensated liver cirrhosis, and worthy of further investigation.

Key words: Liver cirrhosis, Hepatorenal syndrome, Microalbumin, Neutrophil/lymphocyte ratio, Neutrophil gelatinase-associated lipocalin, Diagnosis