Liver diseases are associated with adrenal insufficiency, predominantly in critically ill patients. In our first of kind study, we measured renal resistive index and predicted adrenal insufficiency as measured by serum cortisol level in decompensated cirrhosis patients. Methodology: A prospective observational cohort study done from October 2014 to June 2016 included 100 decompensated cirrhosis patients admitted in Lady Hardinge Medical college, New Delhi. ACTH stimulation test was done with 250mcg/dl, basal cortisol, and cortisol after 60 mins of stimulation was recorded. Renal resistive index was calculated in all patients and charted in excel sheet for statistical analysis. Results: 28% patient were found to have adrenal insufficiency. On univariate analysis, INR, serum total bilirubin, serum creatinine, low HDL, CTP score, MELD score, plasma renin activity level, renal resistive index correlated with patients of adrenal insufficiency. Multivariate analysis showed in patients with adrenal insufficiency, MELD score had odds ratio

Keywords : Cirrhosis, Adrenal insufficiency, ACTH, Renal resistive index, Portal hypertension