Objective Few prospective data are currently available on acute gastrointestinal hemorrhage (AGIH) as a complication in acute kidney injury (AKI).The aim of the present study was to find out clinical characteristics,incidence,etiology,risk factors,and outcome of AGIH in patients with AKI.Methods We performed a prospective study on an inceptione cohprt of 512 patients admitted for AKI in our hospital.Data on clinical risk factors for bleeding,frequency of occurrence of AGIH,in-hospital mortality were collected,and independent predictors of AGIH were identified.Results A total of 53 patients had AGIH as a complication of AKI,and 45 were upper AGIH.Fifteen patients had clinically severe bleeding.Independent baseline predictors of AGIH were severity of illness,cardiac failure,mechanical ventilation,low platelet count,chronic hepatic disease,liever cirrhosis,severe AKI.Inhospital mortality was 52.8％ in patients with AGIH,and 22.2％ in the other patients.AGIH was significantly associated with an increase in hospital mortality.Conclusions AGIH are frequent complications of AKI.In this clinical condition,AGIH is more often due to upper gastrointestinal bleeding and is associated with a significantly increased risk of death.Both renal and extrarenal risk factors are related to the occurrence of AGIH.