急性肾损伤（AKI）是临床常见危重病症，发病率逐年增高。以往AKI的定义和诊断无统一标准，文献中AKI的概念及诊断标准有数十种之多，导致其发病率、病死率等流行病学结果存在很大差异，疗效判定也无法比较，影响了AKI诊治水平的提高。自2002年以来，先后提出了AKI的急性透析质量指导组（ADQI）标准、急性肾损伤网络（AKIN）标准及最新的改善肾脏病全球预后（KDIGO）指南，以统一国际上关于AKI的定义及分期标准，这对于早期识别AKI患者起到积极作用。目前仍然以血清肌酐和尿量变化作为AKI的诊断和分期指标，而血清肌酐并非一个敏感指标，不能及时地反映肾功能变化，尿量也易受利尿剂、尿路梗阻等因素影响，二者作为诊断或分期指标，存在一定不足。因此，寻找新的早期、敏感、可靠的肾脏损伤标志物是未来的发展方向。现就AKI定义形成、诊断标准的演变与研究进展进行回顾及展望。

Acute kidney injury (AKI) is a common clinical critical disorder. Its incidence is increasing gradually. There has been no uniform standard for the definition and diagnosis of AKI since ten years ago, making it difficult to compare the results from different studies. Since 2002, ADQI,AKIN and KDIGO guidelines have been published in succession for the evaluation and management of AKI, respectively. These guidelines have provided the definition and classification of AKI, which are appropriate for defining the epidemiology of AKI and for the design of clinical trials. At present, serum creatinine combined with urine output remains the cornerstone for diagnosing and classifying AKI.However, serum creatinine is not a sensitive index as it can't reflect the change of kidney function in time,and urine output is also susceptible to many factors such as use of diuretics and urinary tract obstruction.Neither of them is perfect as an index for both defining and classifying AKI. Therefore, finding early,sensitive and reliable biomarkers of kidney damage is the future direction of research. In this paper, we have reviewed evolution of the definition, diagnostic criteria, and recent research of AKI.