When normal creatinine hides post-operative kidney injury

The conversation in the surgical ICU happens the same way every time.

“His creatinine spiked post-op, but it came back down before discharge. The labs look normal now. The kidney recovered.”

Cardiac surgeons hear this reassurance so often it’s become standard. The patient leaves the hospital with normal kidney function on the discharge summary. By every conventional metric, the surgery was a success. The acute kidney injury was resolved.

Except it didn’t. Not …

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When normal creatinine hides post-operative kidney injury