Menez S, Moledina DG, Garg AX, et al. - Researchers conducted a sub-study of the prospective cohort –TRIBE-AKI Study– assessing 613 adult patients undergoing cardiac surgery in Canada in the primary analysis in order to determine how various biomarkers are associated with development or progression of chronic kidney disease (CKD) following cardiac surgery. In those with baseline estimated glomerular filtration rate (eGFR) over 60 mL/min/1.73m², a 25% reduction in eGFR and an eGFR under 60 defined CKD incidence. In those with baseline eGFR under 60 mL/min/1.73m², a 50% reduction in eGFR or eGFR under 15 defined CKD progression. In a replication cohort of 310 patients from one study site in the United States, evaluation of results was done. Over a median follow-up of 5.6 years, 172 patients developed the primary composite outcome of CKD incidence or progression. After adjustment for demographic factors, serum creatinine, and albuminuria, each log raise in basic fibroblast growth factor, Kidney Injury Molecule-1, N-terminal prohormone of brain natriuretic peptide, and tumor necrosis factor receptor 1 were linked with outcome. The replication cohort had similar results. Although no interaction was noted by acute kidney injury in continuous analysis, higher mortality was evident in no acute kidney injury group by biomarker tertile. Thus, there was an independent correlation of elevated post-operative levels of blood biomarkers following cardiac surgery with the development of CKD. These biomarkers can yield additional value in estimating CKD incidence and progression after cardiac surgery.