Purpose.To assess the incidence, risk factors and outcomes associated with acute kidney injury (AKI) in kidney transplant in patients using KDIGO classification. Methods- Retrospective cohort analysis was performed on the data of all patients (with at least 3 months after transplantation and more than 16 years old) admitted to the hospital due to medical or surgical complications from 2007 to 2010.Results.Analyzed 458 kidney transplant patients, most of them were male (55.2%), caucasian (60.3%) with comorbidities such as hypertension (74.5%), diabetes mellitus (35.8%) and cardiovascular disease (68.1%). The age was 49 years and 62% received the graft from a deceased donor. The estimated glomerular filtration rate was 63 ml/min. The main cause of hospitalization was infection (60.7%), with a median hospital stay was 10.5 days. The incidence of acute kidney injury was identified in 82.3% by KDIGO. Independent risk factors for AKI were infection (OR=5.7, p<0.001, 95% CI:2.80-13.19), use of iodinated contrast (OR=9.35, p=0.004, 95% CI:2.05-42.70), ICU admission (OR=8.9, p=0.008, 95% CI:1.78-44.57). Fifty-nine patients (13%) required dialysis. Ten patients died, all of them with AKI. Independent risk factors for mortality were hospitalization for cardiovascular causes (OR=21.35, p=0.007, 95% CI:2.32-196.49), use of sedation (OR=23.8, p= 0.007 95% CI:2.41-235.3), use of chemotherapy (OR =21.63, p=0.046, 95% CI:1.06-441.3) and length of ICU stay in days, where each increase of one day in the ICU, we estimate an expected increase of 32% in the risk of death (OR=1.32, p=0.003, CI:10%-59%). Patients with AKI have higher creatinine values when compared to those without AKI, both at baseline (p= 0.007) and after 12 months of follow-up (p<0.001). The study showed that acute renal damage was determined after 12 months of follow-negative impact on graft function over time (p<0.001). Conclusion-Using the KDIGO criteria, we demonstrated a high incidence of this condition in hospitalized patients. The major risk factor for AKI are infection, used of iodinated contrast, ICU hospitalization, presence of rejection and baseline creatinine. AKI could not associate with mortality, because we did not observe deaths in cases classified as not having AKI by 3 stages. The presence of AKI is a risk factor for progression of CKD after 12 months of follow-up.

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