Introduction: Acute kidney injury (AKI) is a common and potentially life-threatening condition among hospitalized patients, marked by an abrupt decline in renal function. It is associated with increased in-hospital complications, mortality, and a heightened risk of long-term renal impairment. The burden of AKI continues to rise due to aging populations, a growing prevalence of comorbid illnesses, and frequent exposure to nephrotoxic insults, particularly in critically ill patients. Aim and Objectives: This study was conducted to evaluate the severity profile and clinical course of AKI in hospitalized adults, with emphasis on staging according to KDIGO criteria, underlying etiologies, associated risk factors, dialysis requirements, and in-hospital outcomes. Materials and Methods: A prospective observational study was carried out over 18 months in the Department of General Medicine at Sree Mookambika Institute of Medical Sciences, Kanyakumari, Tamil Nadu. One hundred adult inpatients diagnosed with AKI based on KDIGO guidelines were included. Demographic details, clinical features, and laboratory findings were recorded. Patients were followed throughout their hospital stay to assess disease progression, need for renal replacement therapy, and outcomes. Statistical analysis was performed using SPSS software. Results: The majority of patients were between 45 and 60 years of age (42%), with a male predominance (65%). Common comorbid conditions included chronic liver disease (10%), hypertension (8%), and diabetes mellitus (6%). Most patients presented with advanced disease, with stage 3 AKI observed in 69% of cases. Sepsis emerged as the leading precipitating factor (26%), followed by envenomation from snakebite (14%) and gastrointestinal illnesses (12%). Nearly half of the cohort (48%) required dialysis, most frequently due to combined metabolic acidosis and anuria (56.25%). Conclusion: AKI among hospitalized patients often presents in advanced stages and frequently necessitates dialysis support. Prompt recognition, identification of precipitating factors, and early intervention are crucial to improving clinical outcomes and minimizing progression to chronic kidney disease.

: Acute kidney injury; KDIGO; sepsis; dialysis; hospitalized patients