Background:Acute kidney injury (AKI) is often asymptomatic, diagnosed through biochemical monitoring indicating elevated blood urea and serum creatinine. The study aimed to assess AKI's etiology, clinical aspects, prognosis, and analyze dialysis utilities. Methods: Aprospective observational hospital-based study was conducted at King George hospital, Visakhapatnam, India, from January 2017 to September 2018.Patients with AKI exhibitedanincrease in serum creatinineof ≥ 0.3 mg/dL (≥ 26.4 micromole/L) were included in study. Results:Of 50 patients, 29 were males and 21 were females.Patient with AKI,oliguria was the predominant presentation in both genders (males 86.20%, females 85.71%). The leading cause of AKI was acute diarrheal diseases (ADD) (32.00%) followed by malaria (24.00%), sepsis-related infections (14.00%) and poisoning (8.00%).In pre-renal AKI patients, ADD (81.25%) emerged as the most common etiology, followed by malaria (66.66%). Pre-renal AKI patients showed a significantly higher prevalence of ADD (81.25%) compared to renal (P=0.02). According to acute kidney injury network (AKIN) criteria, 46.00% patients were in stage 1, 24.00% in stage 2, and 30% in stage 3. Among the AKIN stages, ADD was significantly higher in stage 1 (81.25%, P= 0.0023)and all other etiologies were comparable. Allpatientswere treated conservatively with no mortality in stage 1. In stage 2, 50% patients were treated conservatively, 50% underwent hemodialysis and 16.66% expired. In stage 3, 20% patients were treated conservatively, 80% underwent hemodialysis, and 33% died due to complications. Conclusion:The presentation of AKI is predominantly oliguric, with ADDas the leading cause.Despite low mortality, two-thirds were managed conservatively, while one-third required hemodialysisunless contraindicated.