In a study of 112 high-risk cardiac surgery patients, it was found that the difference in pre-operative and on-bypass mean arterial pressure (MAP) and cardiopulmonary bypass (CPB) flows did not significantly predict early post-surgical acute kidney injury (CSA-AKI). However, baseline serum levels of Neutrophil gelatinase-associated lipocalin (NGAL) and its early post-surgical percent change were strong independent predictors of CSA-AKI development, suggesting its potential as a useful biomarker in identifying patients at risk.