• 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