Acute kidney injury (AKI) associated with sepsis remains an all too common occurrence with an associated high mortality rate. However, recent developments bring hope that this scenario may be changing. This change is being brought about by a multi-pronged approach that highlights several different but inter-related aspects of AKI. These include: (1) defining a standard definition for AKI; (2) understanding the importance of early recognition of AKI; (3) improving imaging techniques for the diagnosis of AKI; (4) improved understanding of the complex pathogenesis of AKI, especially in sepsis; (5) the development of targeted strategies to prevent and treat AKI and (6) an improved understanding of the design and implementation of clinical trials in AKI. Through advances in all of these areas it is hoped that the incidence and mortality rates associated with AKI will be improved.