Aims & Objectives: The aim of this study was to estimate the incidence and prognosis of AKI, besides associated complications and mortality in medium-complexity levels of care (II and III) from the Colombian southeast through KDIGO classification, adhering to the strategy proposed by the International Society of Nephrology: zero preventable deaths by 2025 at developing countries Methods: Multicenter prospective cohort study was conducted, included all children >28 days and <18 years of age, who were admitted to four medium-complexity PICU from Colombian southeast. We included patients with diagnosis of AKI through KDIGO from the emergency service or which was developed during the hospital stay in PICU during the period between January and December 2017. Structural renal abnormality through clinical history, chronic kidney disease and antecedent of renal transplant were excluded. Results: We screened 2,120 patients who were admitted to four PICU during the t period. AKI was diagnosed in 110 patients, according to the KDIGO (cumulative incidence = 5.2% 95%CI 4.3% to 6.2%). Acute kidney injury patients were categorized into three KDIGO stages on admission, as follows: stage I (mild) in 2.5% of total admissions (52 patients), stage II (moderate) in 1.6% (34 patients), and stage III (severe) in 1.1% (24 patients). Seventy-eight patients (71%) reached their maximum KDIGO stage on the first day from the admission to PICU Conclusions: Severe acute kidney injury established and classified according with KDIGO is associated with worse clinical outcomes; early therapeutic efforts must focus on prevention and on limiting the progression to stages 2 and 3.