Early recognition of AKI is essential to ensure prompt and appropriate management, and to avoid progression to late stages of the disease (2) AKI requiring renal replacement therapy occurs in 5-6% of ICU patients, with an extremely high in hospital mortality rate of 60%.6 It is estimated that about 2 million people die of AKI every year. Those who survive AKI have a higher risk for later development of CKD(3). Epidemiology of AKI is understudied in developing countries so further studies are needed to estimate the burden of AKI among ICU patients.

Few studies about the epidemiology of AKI in Egypt were done;

Acute kidney injury is a sudden episode of kidney failure or damage that happens within a few hours or days. According to KDIGO (kidney disease improving global outcomes) criteria: AKI is defined as any of the following: Increase in serum creatinine by 0.3mg/dL or more within 48 hours or. Increase in serum creatinine to 1.5 times baseline or more within the last 7 days or. Urine output less than 0.5 mL/kg/h for 6 hours(1). Kidney Injury (AKI) affects over 13 million people per year globally and results in 1.7 million deaths. Recent hospital studies in the developed world report AKI in 3.2-9.6% of admissions, with overall in-hospital mortality around 20%, and up to 50% in ICU patients.

Early recognition of AKI is essential to ensure prompt and appropriate management, and to avoid progression to late stages of the disease (2) AKI requiring renal replacement therapy occurs in 5-6% of ICU patients, with an extremely high in hospital mortality rate of 60%.6 It is estimated that about 2 million people die of AKI every year. Those who survive AKI have a higher risk for later development of CKD(3). Epidemiology of AKI is understudied in developing countries so further studies are needed to estimate the burden of AKI among ICU patients.

Few studies about the epidemiology of AKI in Egypt were done; Samar Abd ElHafeez e,tal 2017 found in a multicenter study of over 500 consecutive patients admitted to ICUs in Alexandria Teaching Hospitals in Egypt, that about 40% of patients admitted to ICU had AKI at presentation, and a similar proportion of those who were AKI-free on admission developed AKI during their ICU stay (4) .

Up to our knowledge, there are no sufficient data about the epidemiology of AKI in upper Egypt

Inclusion Criteria:

• All patients >18 years admitted to medical ICU in Internal Medicine Department with critical medical conditions who develop AKI during hospital admission or presented with AKI

Exclusion Criteria:

• Patients with ESRD on regular dialysis ,Patients with stage 4 or 5 non-dialysis if the condition proven to be progression of the already known diagnosis.

cases of AKI admitted to ICU in internal medicine department or developed AKI during hospital stay.