Kanchi M, et al. - Whether sodium bicarbonate (NaHCO₃) supplementation in patients with stable chronic kidney disease (CKD) undergoing off-pump coronary artery bypass grafting (OP-CABG) could prevent postoperative acute kidney injury (AKI) was investigated in 60 non-dialysis CKD patients with glomerular filtration rate (GFR) ≤60 ml/min/1.73 m² who needed elective OP-CABG. Random allocation of these patients to NaHCO₃ infusion at 0.5 mmol/kg first hour followed by 0.2 mmol/kg/h till the end of surgery (one group) or to 0.9% sodium chloride (NaCl; other group) was done. They also included a third group of 30 patients without renal dysfunction undergoing OP-CABG. Findings demonstrated that the incidence of Stage-1 AKI was reduced by about 40% due to perioperative infusion of NaHCO₃ during OP-CABG vs NaCl. In comparison to patients with normal renal function undergoing OP-CABG, the NaHCO3 group had a similar incidence of Stage-I AKI.