Introduction: Acute kidney injury (AKI) affects up to 75% of critically ill patients and is one of the causes of admission to intensive care. The objective of this cross-sectional study is to understand the local reality of diagnosing acute kidney injury. Methodology: This cross-sectional study was conducted at the Provincial General Teaching Hospital of Riobamba, Ecuador, from January to June 2024. Patients aged 15 years or older admitted to the Intensive Care Unit were included. Demographic data were collected: age, sex, presence of sepsis, comorbidities, and laboratory variables: creatinine, urea, potassium, calcium, chloride, hemoglobin, leukocytes, procalcitonin, CRP, blood gases, and antibiotics used. KDIGO criteria were used to define the presence of acute kidney injury. The sample was probabilistic. Odds ratios are presented to determine the association between acute kidney failure and the variables. Results: We analyzed 145 patients admitted to the ICU; 90 had AKI (62% (95% CI: 54%-70%). The factors associated with the development of AKI were the use of diuretics OR 11.68 (1.5-90.7) P = 0.004, HBP 9.95 (1.27-77.93) (P = 0.008), the use of diuretics OR 4.25 (2.07-8.72) P < 0.001, Shock 2.67 (1.15-6.18) P = 0.02, Use of vasopressors 2.67 (1.15-6.18) P = 0.02, use of blood derivatives 2.68 (1.29-5.58) P = 0.008. 12.22% required dialysis. Mortality of patients with IRA was 22.2% (13.5-30.98%). Conclusions: In this report, AKI was highly prevalent, and AKI-associated mortality is consistent with international reports.