【Abstract】Objective To evaluate the value of the three general scoring systems (SOFA, APACHE II and SAPS II), the AKI-specific scoring system (Liano), and the RILFE criteria for predicting prognosis in acute kidney injury (AKI) patients. Methods In this prospective and single center study, AKI patients with different causes and hospitalized in this hospital from December 2008 to November 2009 were enrolled. AKI was diagnosed based on the serum creatinine of RIFLE criteria. Patients were excluded from this study if the AKI was due to obstructive uropathy, interstitial nephritis, primary or secondary glomerulonephritis. The primary end point of the study was the mortality after 28 days. Scores from RIFLE classification, SOFA, APACHE II, SAPS II and Liano scoring systems were compared between the survival and non-survival patients. Receiver operating characteristic (ROC) curve for predicting death was used for the evaluation of scoring systems with and without stratification based on RIFLE classification. Results A total of 194 AKI patients were enrolled in this study. No significant differences were found in RIFLE classification, cause of AKI and dialysis between survivor and death groups. However, ventilation therapy, and scores from SOFA, APACHE II, SAPS II and Liano systems were significantly different between survivors and non-survivors. Area under ROC (AUROC) curves for predicting death by SOFA, APACHE II, SAPS II and Liano scores were 0.900, 0.885, 0.888 and 0.875, respectively (P<0.001), which were all higher than the AUROC of RIFLE (0.566, P>0.05). Stratification of AKI based on RIFLE classification revealed that patients in the failure group had higher AUROC of the 4 scoring systems, especially the AUROC of Liano scoring system. Conclusions General or AKI-specific scoring systems including SOFA, APACHE II, SAPS II and Liano systems are superior to RIFLE criteria for predicting prognosis in AKI patients.