What are the recommendations for renal dysfunction during CABG?
Class IIb recommendations for renal dysfunction during CABG include: 1) in patients with preoperative renal dysfunction (creatinine clearance <60 mL/min), off-pump CABG may be reasonable to reduce the risk of acute kidney injury (AKI); 2) in patients with preexisting renal dysfunction undergoing on-pump CABG, maintenance of a perioperative hematocrit greater than 19% and mean arterial pressure greater than 60 mm Hg may be reasonable; 3) in patients with preexisting renal dysfunction, a delay of surgery after coronary angiography may be reasonable until the effect of radiographic contrast material on renal function is assessed; and 4) the effectiveness of pharmacological agents to provide renal protection during cardiac surgery is uncertain.