Dissertation (MMED Paediatric and Child Health)Acute kidney injury (AKI) is increasingly becoming a global health concern and accounts for about 1.4 million deaths worldwide. Critical illness is commonly accompanied with variable degree of acute kidney injury. However, the true burden of AKI in terms of its magnitude, associated risk factors and outcome among critically ill children in Tanzania, is unknown due to limited Data.This study was done to determine the prevalence, risk factors and immediate outcome of acute kidney injury among critically ill children admitted at Dodoma Regional Referral Hospital and Benjamin Mkapa Hospital. This was a prospective cross-section study which enrolled critically ill children aged 1month to 15years, admitted at two referral hospitals in Dodoma region, for a period of 3 months. Variables such as demographics, vital signs, urine output and blood samples were taken. AKI was defined using Kidney Disease Improving Global Outcome (KDIGO) criteria. Data were analysed using SPSS version 25 and the results were considered significant when the p-value was <0.05. The prevalence of AKI was 57.6% (53/92), after controlling other factors, patients with impaired consciousness (p=0.0071), severe respiratory distress (p=0.0016), multiple convulsions at admission (p=0.0487), duration of illness of more than 3days (p= 0.0012), absence of chronic illness (p=0.028), and presence of protein in the urine (p=0.0135), were independently associated with AKI. Patients with AKI had longer duration of hospital stay, averaging 11days and higher proportion of death of 35.8% (19/53) . Increasing AKI stage, and young age (1-12) months, were found to be predominant risk factors for mortality. The need for dialysis was 12/53 (22.6%); but only two patients could afford dialysis. AKI is very common in critically ill children especially those with impaired consciousness, severe respiratory distress, duration of illness of more than 3 days, absence of chronic illness, history of multiple convulsions at admission and proteinuria.