Renal impairment is one of the severe non communicable disease around the world. Especially patients of diagnosed/newly diagnosed renal impairment those who needed surgery are more focused for preoperative and postoperative preparation. Serum creatinine is the prime biochemical marker for assessing renal function and level of impairment is widely measured by this marker as well as Glomerular Filtration Rate (GFR). Objective: Factors responsible for serum creatinine fluctuation in preoperative and postoperative period and its minimizing process the ultimate goal of this study. Method: 37 patients were participated in this cross sectional study who were being previously diagnosed/newly diagnosed. They were admitted in different tertiary level hospitals for emergency or elective surgery.15 patients were admitted in renal function impairment stage, 22 were admitted as normal patients. Values of creatinine at pre admission stage and 2^nd/3^rd post admission follow up were compared .Results: 0.41 was the average of 22 patients creatinine between pre admission and 2^nd/3^rd follow up. The responsible factor like prolonged staying, immobilization, co-morbidities, different preoperative antibiotics, NSAIDs were also inducer for creatinine elevation. After postoperative hemodialysis rapid decrease of creatinine seen on normal patients but this decrease very much minor on CKD diagnosed patients.