Using a similar approach, an early identification of “high risk AKI patients” by using a combination of biomarkers such as [TIMP-2]·[IGFBP7] reduced the risk of AKI related to cardiac surgery from 71.7% to 55.1% (p = 0.004) through an strictly controlled implementation of the KDIGO guidelines, avoiding nephrotoxic agents and radiocontrast agents, discontinuing ACEi and ARBs, monitoring serum creatinine and urine output closely, avoiding hyperglycemia and optimizing the volume status and hemodynamic parameters by using a PICCO catheter and a pre-specified algorithm [38]. Here, TIMP2 is linked to acute kidney injury.