Dopamine at low doses increases renal blood flow and blocks the tubular reabsorption of sodium. A meta-anal- ysis on the use of low-dose dopamine reported that it increased urine output and improved serum creatinine con- centrations without influencing the need for renal replace- ment therapy or the rates of adverse events or death.990 Diltiazem and mannitol have been used to prevent AKI after cardiac surgery.988 Diltiazem may inhibit the inflamma- tory response that occurs with CPB,992 whereas mannitol produces an osmotic diuresis.1000 The role of mannitol in preventing AKI is unclear.983,1004 Diltiazem does not prevent Hillis et al 2011 ACCF/AHA CABG Guideline e691 renal dysfunction.983 Contrast-induced nephropathy is a com- mon cause of AKI. It is usually self-limited and manifests its peak effect 3 to 5 days after the administration of contrast material. In patients with preoperative renal dysfunction, it is reasonable to delay surgery for several days after coronary angiography to reduce the incidence of AKI.979 981 5.2.4. Perioperative Myocardial Dysfunction: Recommendations Class IIa 1. In the absence of severe, symptomatic aorto-iliac occlusive disease or PAD, the insertion of an in- traaortic balloon is reasonable to reduce mortality rate in CABG patients who are considered to be at high risk (eg, those who are undergoing reoperation or have LVEF <30% or left main CAD).1021 1026 (Level of Evidence: B) 2. 