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Acute kidney injury after cardiopulmonary bypass (post-CPB AKI) was a common postoperative complication, and correlated with postoperative morbidity and mortality, especially in pediatric population.Plasma gelsolin (pGSN), as a novel inflammatory mediator, had been proposed to engage in various tissue injury related to inflammation.In this study, 77 patients ≤ 3 years of age undergoing CPB were enrolled, and were assigned to AKI and non-AKI groups according to pRIFLE criteria.PGSN levels were analyzed at 8 perioperative time points, and their predictive value and relationships with clinical outcomes were investigated.The results showed that both pGSN and normalized pGSN (pGSNN) of AKI patients declined immediately after CPB, and reached the nadir level at 2 hours;pGSN and pGSNN at 2 hours after CPB were negatively associated with the severity of AKI.CPB duration was the only independent predictor of AKI in clinical model;model discriminations showed significant improvement of AUCs after adding pGSN and pGSNN at 2 hours after CPB into clinical model respectively.In conclusion, pGSN was an early predictor for post-CPB AKI in infants and young children, and negative correlated with the severity of AKI.Combination pGSN with clinical variables could improve the predictive value for post-CPB AKI.