This study aimed to develop a dynamic predictive model for cardiac surgery-associated acute kidney injury (CSA-AKI), using data from 910 cardiac surgery patients to combine preoperative risks and cardiopulmonary bypass (CPB) related factors into a multifactorial dynamic perfusion index (MDPI). The study found that the MDPI, which includes dynamic CPB quality indices, has better predictive ability for CSA-AKI than existing static models, suggesting its potential as a more effective tool for integrating various risk factors in patient care.