Dissertation (MMED Pediatric and Child Health)Acute kidney injury (AKI) is recognized complication in neonates with birth asphyxia. In all neonates with birth asphyxia the emphasis should be laid on early identification of AKI, so that it can provides the way of timely and appropriate management by avoiding consequences of irreversible renal failure. However, the true burden of AKI in terms of its magnitude and associated predictors among term babies with birth asphyxia in Tanzania is unknown due to limited Data. This study was done todetermine the prevalence and predictors of acute kidney injury in term babies with birth asphyxia admitted at Dodoma regional referral hospital neonatal ward. This was across-section study which enrolledterm babies admitted at DRRH neonatal ward with diagnosis of birth asphyxia in a period of 6 months from August, 2020 to January, 2021. Variables such as demographics and blood samples were taken. AKI was defined using Kidney Disease Improving Global Outcome (KDIGO) criteria. Data were analysed using SPSS version 26. A total of 187 neonates with birth asphyxia were recruited, male neonates were 96/187(51.3%) and female neonates were 91/187.20/187(10.7%) of neonates had AKI.After controlling other factors, the independent predictors of AKI included shock (aOR 4.6, 95% CI [1.2-21.8], p=0.025),clinical neonatal sepsis(aOR 17.7, 95% CI [4.2-69.7], p<0.001), prolonged labor(aOR 28, 95% CI [2.9-348.97], p<0.004) and maternal gentamicin use(aOR 4.8, 95% CI [1.9-26.7], p<0.003) were statistically significant associated with AKI. AKI was very common interm neonates with birth asphyxia. Predictors of AKI in term neonates with birth asphyxia included, clinical sepsis, shock, prolonged labour and maternal gentamicin use.