Acute kidney injury (AKI) is a common clinical acute and critical illness. The incidence of AKI and mortality in hospitalized patients increased year by year, which consumed a lot of health care resources. China continues to increase spending on health care, and primary health services have made great progress, but prevention and treatment of AKI between urban and rural areas, and among the hospitals of three grades, are still largely different, especially the recognition and treatment principle are not well mastered, resulting in a low rate of diagnosis and high hospital mortality in AKI patients. In this paper, for the characteristics of physicians in primary hospitals, a systematic summary has been made for new recognition of the pathogenesis and the guidelines for management of AKI, and for questions from the management of AKI, hoping to deepen the awareness for AKI, to improve its diagnosis and treatment, and to reduce the mortality of patients with AKI.