This doesn't surprise me. Although a hospital might be able to benefit from claiming less kidney complications, if they were doing something that was considered to be outside of SOP, it might open them up to malpractice costs if there were something to go wrong. That, and the delayed benefit might be enough inertia. Of course, in this case (and in many others) this is a bad thing. However, on the other hand, such caution can prevent doctors from taking unfounded risks with patients. Medical treatment is muddy water. Ethics, money, and lives. As an aside, work hard to get the best medical advice and treatment you can. Be proactive. It is a very imperfect system, and a little effort can make all the difference. A patient that was to undergo cardiac surgery could suggest doing this, and a doctor could agree to it.