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Background—Acute kidney injury is a risk factor for mortality in cardiac surgery patients. Nicotinamide adenine dinucleotide (NAD+) is a cofactor for numerous enzymes involved in cellular energy metabolism, and for adaptive responses of cells to bioenergetics and oxidative stress and is now a major player in aging and age-related diseases. Urine Albumin/Creatinine/Ratio have an important role in the early diagnosis of renal injury post-cardiac surgery, urinary QPRT may have a role in detecting niacin deficiency Method: Using cohort - study design based on 90 subjects all patients subjected to open-heart surgery, were divided into two groups according to the dosing of niacin (vitamin B3) we measured Urine QPRT and Albumin/Creatinine/Ratio at baseline, before surgery, 1 day after surgery, one week after surgery. Results: Urine Albumin/Creatinine/Ratio significantly elevated (p≤0.05) in the control group (subjects who didn´t receive vitamin B3 supplement from baseline while those who receive vitamin B3 supplement show stable Urine QPRT and Albumin/Creatinine/Ratio level. Conclusion: vitamin B3 (niacin) has a beneficial role in renal protection after cardiac surgery.