Background: rnAcute kidney injury (AKI) in developing countries is the disease of the young and children whilerndeveloped countries elderly patients with co morbid conditions predominate. The management ofrnpatients with acute kidney injury (AKI) is supportive, with renal replacement therapy (RRT)rnindicated in patients with severe kidney injury. rnEven though, government run dialysis service is given in few centers in Ethiopia, data onrnepidemiological and clinical characteristics of dialysis requiring AKI patients and its outcome is rnsparse. rnObjectives: rn The objective of this study is to describe socio-demographic, clinical characteristics of patientsrnwith dialysis requiring AKI and their renal and hospital outcome at Tikur Anbessa SpecializedrnHospital, Addis Ababa, Ethiopia. rnMethods: rnThe study is an institution based retrospective chart review of patients with AKI who werernhospitalized and had hemodialysis inTikur Anbessa Specialized Hospital, Addis Ababa, Ethiopiarnfrom July 14, 2016 to September 2019. Data on socio-demographic characteristics, clinicalrnprofiles, and dialysis and hospital outcomes were collected using a structured questionnaire. Datarnentry and analysis was done on (SPSS) version 20. Frequency tables and odds ratio was used tornexplain and analyze the results. Factors found to be significantly associated with mortality onrnbivariate analysis (P-value< 0.05) were analyzed with a multivariate model using logisticrnregression to determine the predictors of in-hospital mortality. P values less than 0.05 werernconsidered statistically significant. rnResult rnA total 275 patients underwent hemodialyis during the period, of which 130 patients, 71 females rn(54.6%) and 59 males(45.6%), with a median age of 34 were included in the study. The mostrncommon causes of AKI were sepsis (33.8%), glomerulonephritis(31.5%) and pregnancy related causes (16.2%). A quarter of the patients (25.4%) did require ICU admission. The in hospitalrnmortality was 26.2%. Sepsis, co morbid heart failure and age above 50 year were associatedrnwith increased mortality. In 12(9.2%) patientsâ€™ glomerulonephritis as a cause of AKI increasedrnthe risk of dialysis requirement beyond 4 weeks. rnConclusion rnIn this setting the majority of patients with dialysis requiring AKI are young. We have observedrna shift in the etiology of dialysis requiring AKI in the last two decades; from Malaria and septicrnabortion predominated to sepsis and glomerulonephritis.