• 1,219 adult cardiac surgery patients

• AKI = need for RRT or 2-fold rise in creatinine

• Urine IL-18 and plasma NGAL peaked within 6 hours

• Highest quintiles of both had >5-fold odds of AKI

• Associated with more adverse outcomes – death, LOS

• Addition of both improved ROC for AKI over clinical predictors alone

So what can we do?Early Detection

Parikh CR, et al. J Am Soc Nephrol 2011 Sep;22(9): 1748-57