Renal dysfunction occurring during or after surgery can be diagnosed when certain laboratory findings are present.
Criteria for renal dysfunction - one or more of the following:
(1) serum creatinine > 2.0 mg/dL with preoperative value < 2.0 mg/dL
(2) increase >= 50% in serum creatinine if preoperative creatinine elevated
(3) need for dialysis in a patient with adequate renal function prior to surgery
where:
• The normal ranges for serum creatinine not given. Since the authors are from the Mayo Clinic I assume that I can use the normal ranges from there.
• The first rule would fire with a preoperative creatinine of 1.9 and postoperative 2.1. Since the upper limit of the normal reference range for serum creatinine is 1.3, I will use < 1.3 for the first rule.
Limitations:
• Elderly patients may have renal dysfunction with low serum creatinine values. Measurement of creatinine clearance might be more sensitive in this population for detecting mild dysfunction.
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