Objective: to identify the influence of variations on serum creatinine on outcomes of patients with acute kidney failure. Methods: observational and prospective study. Eighty-five patients which evolved with renal impairment composed the sample. The data was extracted from medical records and reported in a questionnaire created previously. It was considered values p≤0.05 as significant. Results: most of patients were male gender (51.8%) and elder (66±14 years). The reduction of kidney function occurred in different graduation, considering that 35.3% evolved with risk to kidney injury (stage 1) and lower percentage (14.1%) was more severely affected (stage 2 and 3), respectively. During follow-up, the clearance creatinine progressively increased showing recovery of kidney function. Patients with renal injury or failure (stage 2 or 3) evolved more frequently to death (p=0,027). Conclusion: variations on serum creatinine may exacerbate the patient outcomes over hospitalization period. Descriptors: Acute Kidney Injury; Creatinine; Mortality. Objetivo: identificar a influência de variações na creatinina sérica sobre o desfecho dos pacientes com lesão renal aguda. Métodos: estudo observacional prospectivo. A amostra foi composta de 85 pacientes que evoluíram com comprometimento renal. Os dados foram extraídos do prontuário e registrados em questionário construído previamente. Valores com p≤0,05 foram considerados significativos. Resultados: a maioria dos pacientes era do sexo masculino (51,8%) e idosos (66±14 anos). A redução da função renal ocorreu em graduações diferentes, haja vista que 35,3% evoluiu com risco para lesão renal (estágio 1) e um menor percentual (14,1%) foi acometido mais gravemente (estágios 2 e 3), respectivamente. O clearance de creatinina aumentou progressivamente revelando recuperação da função renal ao longo do acompanhamento. Pacientes com lesão ou falência renal (estágios 2 ou 3) evoluíram mais frequentemente ao óbito (p=0,027). Conclusão: variações na creatinina sérica podem agravar o desfecho do paciente ao longo do período de internação. Descritores: Lesão Renal Aguda; Creatinina; Mortalidade.
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