Table 2.

Brief overview of recommendations to prevent acute kidney injury and initiation of dialysis by phase of care intraoperative recommendations.

For patients undergoing cardiac surgery with CPB	Avoid hyperthermic perfusion (arterial catheter >37°C) (Class I, Level B-R) Avoid nadir DO2 <270 mL/min/m2 (Class I, Level B-R) Consider minimally invasive extracorporeal circulation techniques (Class IIB, Level B-R) Consider fenoldopam infusion during CPB and perioperatively (Class IIB, Level B-R) … DO NOT USE dopamine infusion for renal protection during CPB and perioperatively (Class III: No Benefit, Level A) DO NOT USE mannitol to prime CPB for renal protection (Class III: No Benefit, Level B-R)
Postoperative recommendations
High AKI-risk patients: elevations in [TIMP-2]*[IGFBP7] ≥.3	KDIGO practice guidelines can be effective: close hemodynamic monitoring and goal-directed volume resuscitation avoidance of nephrotoxic substances hold ACEi/ARB for 48 hours serial serum creatinine and urine output monitoring prevention of hyperglycemia (Class IIA, Level B-R)

ACEi, angiotensin-converting enzyme inhibitor; AKI, acute kidney injury; ARB, angiotensin-receptor blocker; CPB, cardiopulmonary bypass; DO₂, oxygen delivery; IGFBP7, insulin-like growth factor-binding protein 7; KDIGO, Kidney Disease Improving Global Outcomes; TIMP2, tissue inhibitor of metalloproteinases 2.