Background Acute kidney injury (AKI) has a high in-hospital mortality rate, requiring better prognostic tools. The uric acid to HDL cholesterol ratio (UHR), a novel biomarker of metabolic inflammation, was investigated for predicting mortality in AKI patients. Methods A retrospective cohort study was conducted from January 2021 to January 2024, including 500 adult AKI patients diagnosed according to KDIGO criteria. Patients with chronic kidney disease requiring dialysis, those transferred to oth