Wang JJ, et al. - In this prospectively conducted multicenter study, researchers sought to determine the ability of novel biomarkers in combination with clinical risk scores for prediction of advanced acute kidney injury (AKI) after cardiovascular surgery. Urinary hemojuvelin (uHJV), kidney injury molecule-1 (uKIM-1), neutrophil gelatinase-associated lipocalin (uNGAL), α-glutathione S-transferase (uα-GST) and π-glutathione S-transferase (uπ-GST) were measured. Significantly higher levels of uHJV and uKIM-1 at 3, 6 and 12 h after surgery were detected in patients with advanced AKI. At 3 h post-operation, a high predictive ability of uKIM-1 in combination with uHJV for advanced AKI and composite outcome was observed, after normalization by urinary creatinine level. Higher risk of progression to advanced AKI and composite outcomes could be detected in an enhanced manner by adding normalized uHJV and uKIM-1 levels at 3 h after cardiovascular surgery to Liano’s score