We would like to add to the recent editorial by McMahon on biomarkers of acute kidney injury (AKI), with a specific focus on biomarkers in the clinical setting of cardiac surgery-associated AKI (CSA-AKI). We agree with McMahon that biomarkers may aid in the early diagnosis of AKI and that they represent an excellent tool for predicting treatment response. Their role may be pivotal in CSA-AKI, since the pre-operative identification of high-risk patients remains challenging. Most pre-operative AKI prognostication tools include patient-specific risk factors, comorbidities and type of surgery. We propose that incorporating one or more bio-markers into this battery of tools will improve the defini-tion of individual susceptibility to AKI and could support decision-making, pre-operative optimization and outcome improvement.

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