Renal dysfunction after coronary artery bypass grafting is common and is associated with increased morbidity and mortality. A number of strategies with potential renoprotective effects have been investigated, but no single one has been found to warrant routine use in CABG except fenoldopam in which the data to date appear promising. Other measures such as avoidance of nephrotoxic agents, including recent radiocontrast for coronary angiography, may reduce the incidence of renal dysfunction after cardiac surgery and should be implemented in routine care, whenever possible. The best renal protection strategy remains the same as for other organ protection and consists of optimizing haemodynamics, oxygenation, metabolic states and hydration.