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Perioperative changes in serum creatinine after gynecologic surgery
Andrew J Walter1, Paul M Magtibay, Abraham N Morse
1Department of Obstetrics and Gynecology, David Grant Medical Center, Travis Air Force Base, Calif., USA.
American Journal of Obstetrics and Gynecology
|June 18, 2002
Summary
Postoperative serum creatinine levels change minimally after major gynecologic surgery when ureteral patency is confirmed. Creatinine elevations were consistently less than 0.3 mg/dL in patients without ureteral compromise.
Area of Science:
- Nephrology
- Urology
- Gynecologic Surgery
Background:
- Postoperative changes in serum creatinine can indicate ureteral compromise.
- Establishing normal creatinine ranges is crucial for accurate diagnosis.
Purpose of the Study:
- To prospectively determine the normal range of postoperative serum creatinine changes.
- To correlate these changes with confirmed bilateral ureteral patency.
Main Methods:
- Prospective evaluation of 187 patients undergoing major gynecologic surgery.
- Perioperative cystoscopy to confirm ureteral patency.
- Serum creatinine measurement before and 24 hours post-surgery.
Main Results:
- Mean serum creatinine change was 0.01 mg/dL.
- The 95% range for creatinine change was -0.2 to 0.3 mg/dL.
- An increase >0.2 mg/dL had 98% specificity and 100% negative predictive value for ureteral obstruction.
Conclusions:
- Serum creatinine levels exhibit minimal change postoperatively without ureteral compromise.
- In patients with confirmed bilateral ureteral patency, creatinine elevations were always <0.3 mg/dL.