Introduction: Epidemiological data on AKI from an urban district is very limited. There is even less attention paid on the prevalence of community acquired AKI (CA-AKI) versus hospital acquired AKI (HA-AKI). Early detection and management of AKI will improve patients' outcomes and reduce the burden of disease. Objective: To study the incidence and short term outcomes of patient with CA-AKI versus HA-AKI in a district hospital. Method: A retrospective cohort study of general medical admissions to Hospital Kajang between 1st November 2016 to 31st December 2016 was conducted. Case notes of all patients were reviewed. Based on Kidney Disease: Improving Global Outcome (KDIGO) classification for AKI, the patients with serum creatinine increased 26mmol/L or more than the baseline during admission identified into CA-AKI group whereas HA-AKI was defined as the development of AKI at any time after 48 hours of hospitalization. The treatment outcomes were recorded on discharge day. Data was statistically analyzed. Result: A total of 1319 adult were admitted to general medical wards. There were 105 (56.5%) male and 81 (43.5%) female having AKI, giving a total of 186 patients. The incidence of AKI was 14.1%. Mean age of the AKI patients was 55.6 years old. In this study, 135 (72.6%) patients developed AKI in the community, whereas 51 (27.4%) patients had AKI during hospital stay. Average length of stay for CA-AKI versus HA-AKI patients was 6.8 days and 9.1 days respectively; P¼0.06. Patients with CA-AKI had lower inpatient mortality (15.6% versus 47.1% in HA-AKI group; P<0.001). Among CA-AKI patients, 76 (66%) had recovery of renal function compared to 10 (37%) patients in HA-AKI group; (P<0.01). Meanwhile, HA-AKI patient is more likely to be labeled as having de novo CKD as compared to patients with CA-AKI (63% versus 34%; P<0.005). Renal replacement therapy was done to 11 (5.9%) patients and only 19 (13%) patients had renal follow up after discharge. Conclusion: CA-AKI carries better implication in terms of development of progressive renal disease and inpatient mortality.

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