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Purpose: Cardiac surgery associated acute kidney injury (CSA-AKI) is a contributor to adverse outcomes. Preventive measures reduce AKI incidence in high risk patients, identified by biomarkers [TIMP-2]*[IGFBP7] (Nephrocheck®). This study investigate clinical AKI risk assessment by healthcare professionals and the added value of the biomarker result., Materials and Methods: Adult patients were prospectively included. Healthcare professionals predicted CSA-AKI, with and without biomarker result knowledge. Predicted outcomes were AKI based on creatinine, AKI stage 3 on urine output, anuria and use of kidney replacement therapy (KRT)., Results: One-hundred patients were included. Consultant and ICU residents were best in AKI prediction, respectively AUROC 0.769 (95% CI, 0.672-0.850) and 0.702 (95% CI, 0.599-0.791). AUROC of NephroCheck® was 0.541 (95% CI, 0.438-0.642). AKI 3 occurred in only 4 patients; there was no anuria or use of KRT. ICU nurses and ICU residents had an AUROC for prediction of AKI 3 of respectively 0.867 (95% CI, 0.780-0.929) and 0.809 (95% CI, 0.716-0.883); for NephroCheck® this was 0.838 (95% CI, 0.750-0.904)., Conclusions: Healthcare professionals performed poor or fair in predicting CSA-AKI and knowledge of Nephrocheck® result did not improved prediction. No conclusions could be made for prediction of severe AKI, due to limited number of events., Competing Interests: Declaration of Competing Interest AZ received consulting and lecture fees as well as independent research grants from Astute Medical, BioMerieux, Baxter, and Fresenius. MM Received lecture fees from Astute Medical, Baxter and FMC. JD is a consultant for Accelerate Diagnostics, Bayer Healthcare, MSD and Pfizer (honorarium paid to institution for all). EH Participated in several clinical studies sponsored by Astute Medical, lecturing fees from Alexion, Sopachem (paid to the institution) and travel fee from AM Pharma. All other authors declared no competing interests., (Copyright © 2021 Elsevier Inc. All rights reserved.)