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This study aims to evaluate the diagnostic and prognostic utility of Neutrophil gelatinase-associated lipocalin (NGAL), Kidney injury molecule-1 (KIM-1), and interleukin-18 (IL-18) in cirrhotic patients with AKI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This prospective cohort study was conducted at a tertiary care hospital in northeast India. Patients (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009100) were divided into cases comprising decompensated cirrhosis with AKI (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950) and controls comprising decompensated cirrhosis without AKI (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200950). Cases included patients with acute tubular necrosis (ATN) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200910), hepatorenal syndrome (HRS) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918), and prerenal azotemia (PRA) (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922). Urinary NGAL, IL-18 and KIM-1 were analyzed statistically to distinguish the causes of AKI and predict 90-day mortality.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      NGAL [cutoff: 339.6 pg\/mL, sensitivity: 80%, specificity: 83.3%, Area Under the Receiver Operating Characteristic Curve (AUROC): 0.867] and IL-18 (cutoff: 67.75 pg\/mL, sensitivity: 70%, specificity: 88.9%, AUROC: 0.839) differentiated ATN from HRS. NGAL (cutoff: 358.15 pg\/mL, AUROC: 0.878) and IL-18 (67.75 pg\/mL, AUROC: 0.885) distinguished ATN from non-ATN cases. IL-18 (cutoff: 30.95 pg\/mL, AUROC: 0.732) effectively differentiated HRS from PRA cases. KIM-1 had a modest diagnostic performance comparable to serum creatinine. NGAL significantly predicted 90-day mortality (Adjusted Odds Ratio: 1.024;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.014).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Both IL-18 and NGAL can assist clinicians in differentiating the causes of AKI while improving the prognostic ability of existing scores in DCLD patients.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-025-04462-1","type":"journal-article","created":{"date-parts":[[2025,12,7]],"date-time":"2025-12-07T03:54:16Z","timestamp":1765079656000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Novel urinary biomarkers to differentiate AKI etiologies and predict mortality in decompensated cirrhosis patients: a prospective cohort study"],"prefix":"10.1186","volume":"26","author":[{"given":"Chiranjita","family":"Phukan","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anjan Jyoti","family":"Talukdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sangitanjan","family":"Dutta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saptadweep","family":"Saha","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Monalisha Saikia","family":"Borah","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinku Mani","family":"Talukdar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhaskar Jyoti","family":"Sarma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Achyut Chandra","family":"Baishya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saswati Sanyal","family":"Choudhury","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anuradha","family":"Deuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,7]]},"reference":[{"issue":"2","key":"4462_CR1","doi-asserted-by":"publisher","first-page":"135","DOI":"10.14218\/JCTH.2019.00060","volume":"8","author":"R Tariq","year":"2020","unstructured":"Tariq R, Hadi Y, Chahal K, Reddy S, Salameh H, Singal AK. 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