Introduction. Patients who develop acute kidney injury (AKI) have a worse course of the disease and poorer treatment outcomes. The objective of the study. Assessment of clinical evolution in patients with AKI. Material and methods. The study included 141 patients who required hemodialysis (HD) treatment in the Nephrology and Dialysis department, Holy Trinity Municipal Clinical Hospital during 2022. In total 1699 sessions of HD were performed in these patients. Results. 85 (60.28%) males and 56 (39.71%) females. A total of 30 (21.27%) patients had AKI, which required a total of 110 (6.59%) HD sessions. There were 10 (33.33%) females, in the age group of 61-73, the mean age was 72 years. The clinical evolution was 3 (30%) discharges and 7 (70%) deaths. There were 20 (66.66%) males, aged 25-80 years, the mean age was 58 years. The clinical evolution was 11 (55.5%) discharges, 3 (15.0%) chronic HD and 6 (30%) deaths. The AKI cases outcome were as follows: 3 (10.00%) chronic HD, 14 (46.66%) were discharged, and 13 (43.33%) died. The distribution according to the causes of AKI was: acute intoxication - 1; acute alcohol intoxication1; intoxication of unknown etiology- 1; acute urine retention - 1; chronic glomerulonephritis - 1; hypovolemic shock - 2; acute pyelonephritis - 2; diabetic nephropathy - 3; chronic pyelonephritis 4, unknown cause - 14. Conclusions. AKI has a high mortality rate, predominantly in the female and patients over 65 years old, thus early initiation of HD is necessary for treatment and survival.