['Acute renal failure (ARF) after cardiac surgery is a serious adverse event that is associated with high perioperative mortality and prolonged hospitalization. The aim of our study was to evaluate pre- and intraoperative risk factors for the development of ARF requiring hemofiltration after cardiac surgery.', 'From February 2002 through February 2003, 913 patients underwent cardiac surgery at our institution. Seventy-three patients developed ARF (8.1%), 16 patients were excluded from the study because of chronic end-stage renal insufficiency. Patient characteristics and operative variables were analyzed. A multivariate logistic regression analysis was performed to determine risk factors for ARF.', 'Patients who developed ARF were older (P < .001; odds ratio [OR], 1.084; 95% confidence interval [CI], 1.0371.133) than patients who did not develop ARF. Furthermore, cardiopulmonary bypass duration (P = .007; OR, 1.013; 95% CI, 1.004-1.032) and emergent surgery (P = .011; OR, 6.667; CI, 1.538-28.571) were predictive for development of ARF. The strongest predictor for ARF was a preoperative creatinine level >or=2 mg/dL (P < .001; OR, 97.519; 95% CI, 22.363425.252). Most interestingly, even moderately elevated preoperative creatinine levels (1.3-1.99 mg/dL) independently predict ARF after cardiac surgery (P = .001; OR, 3.838; 95% CI, 1.793-8.217).'] Does slightly elevated serum creatinine predict renal failure requiring hemofiltration after cardiac surgery?