In this prospective cohort study of adults undergoing cardiac surgery, we evaluated urinary EGF, MCP-1, and the EGF/MCP-1 ratio and found that higher postoperative levels of urinary EGF and EGF/MCP-1 were independently associated with a lower risk of the composite CKD outcome, whereas higher postoperative levels of urinary MCP-1 were associated with higher risk. This evidence concerns the gene EGF and chronic kidney disease.