['To investigate if urine albumin-to-creatinine ratio (UACR) is associated with the presence of glomerular filtration rate (GFR) <60\xa0mL/min, severity of liver disease and survival in patients with stable decompensated cirrhosis.', 'We evaluated prospectively 220 patients (73\xa0% male, age 52.8\xa0±\xa012\xa0years). In each patient, assessment of GFR was based on ', 'Thirty-eight patients (17\xa0%, group 1) had UACR ≥30\xa0mg/g and 182 (83\xa0%, group 2) had UACR <30\xa0mg/g. Group 1, compared to group 2 patients, had significantly lower levels of "true" GFR (61 vs. 71\xa0ml/min, p\xa0=\xa00.035). Patients with "true" GFR <60\xa0mL/min (n\xa0=\xa093), compared to those with "true" GFR ≥60\xa0mL/min (n\xa0=\xa0127), had higher levels of UACR (16 vs. 11.3\xa0mg/g, p\xa0=\xa00.023). In multivariate analysis, serum creatinine and UACR (ΟR 0.98, 95\xa0% CI 0.95-0.99, p\xa0=\xa00.04) were independently associated with the presence of GFR <60\xa0mL/min. Based on the area under the ROC curves, the best cut-off point for UACR was >16.51\xa0mg/g giving a sensitivity 70\xa0%, specificity 49\xa0%, PPV 68\xa0% and NPV 51\xa0%. During the follow-up period [17 (6-52) months], the patients who died or underwent LT (n\xa0=\xa0158), compared to those who remained alive (n\xa0=\xa062), had higher levels of UACR (41 vs. 13\xa0mg/g, p\xa0=\xa00.025). Patients with UACR ≥30\xa0mg/g had worse outcome, compared to those with UACR <30\xa0mg/g (log rank p\xa0=\xa00.053).'] Is urine albumin-to-creatinine ratio associated with the severity of liver disease , renal function and survival in patients with decompensated cirrhosis?