Medicinal, Psychological, and Health Research Journal (MPHRJ)

Serum Creatinine Dynamics During the First 48 Hours After Major Surgery Following Intraoperative Diuretic Administration

Document Type : Original Article

Authors

Naghi Abedini 1
Yashar Eslampoor 2

1 Associate Professor of Anesthesiology, Department of Anesthesiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

2 Assistant Professor of Anesthesiology, Department of Anesthesiology, School of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran

https://doi.org/10.22034/mphrj.2026.586271.1096
Abstract
Introduction: Serum creatinine continues to serve as a key marker for evaluating renal function in the perioperative setting. The early postoperative period, particularly the first 48 hours after major surgery, is a critical timeframe during which subtle biochemical changes may signal evolving kidney stress or injury.

Material and methods: This prospective observational study was conducted in 2025 at Shohada Hospital, Tabriz, to evaluate serum creatinine changes during the first 48 postoperative hours following intraoperative furosemide administration in major surgery patients. Fifty participants were enrolled through convenience sampling. Serum creatinine was measured preoperatively and every six hours postoperatively.

Results: Serum creatinine increased significantly during the first 48 postoperative hours following intraoperative diuretic administration, rising from a baseline median of 0.96 mg/dL (IQR: 0.84–1.10) to a peak of 1.15 mg/dL (IQR: 1.00–1.35) at approximately 30 hours (P < 0.001). Patients aged ≥45 years demonstrated greater postoperative elevations than younger individuals (P=0.018), while female patients showed slightly higher mid postoperative creatinine levels compared with males (P=0.041). Despite these differences, creatinine values gradually declined toward baseline by 48 hours.

Conclusion: Intraoperative diuretic administration was associated with temporary postoperative changes in serum creatinine that remained clinically modest and largely reversible. Advanced age and female sex appeared to influence the magnitude of renal biochemical responses. Careful perioperative renal monitoring, particularly in older patients, may help optimize postoperative management and facilitate early identification of transient renal function changes.

Graphical Abstract

Serum Creatinine Dynamics During the First 48 Hours After Major Surgery Following Intraoperative Diuretic Administration

Keywords

Serum creatinine
Diuretics
Postoperative renal function
Aging
Perioperative monitoring
Subjects
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Medicinal, Psychological, and Health Research Journal (MPHRJ)
Volume 2, Issue 4
July and August 2026
Pages 285-294

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