Abstract: The morbidity of acute kidney injury(AKI) has been increasing year by year, with high mortality and poor prognosis.In recent years, researches highlight the drug discovery for prevention and treatment of AKI.However, there's still a gap between research and clinical practice.In this paper, we have divided the drugs into three types:drugs with inhibitory activities of cell death, anti-inflammatory drugs, and repair drugs, according to their pharmacological mechanism.Then, the pharmacological mechanism and advances of them are analyzed and summarized.Also, we analyze the reasons of the failure of drug development, which may promote the prevention, treatment and prognosis of AKI.