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The kidneys have a close functional relationship with other organs especially the lungs.This connection makes the kidney and the lungs as the most organs involved in the multi-organ failure syndrome.The combination of acute lung injury (ALI) and renal failure results a great clinical significance of 80％ mortality rate.Acute kidney injury (AKI) leads to an increase in circulating cytokines,chemokines,activated innate immune cells and diffuse of these agents to other organs such as the lungs.These factors initiate pathological cascade that ultimately leads to ALI and acute respiratory distress syndrome (ARDS).We comprehensively searched the English medical literature focusing on AKI,ALI,organs cross talk,renal failure,multi organ failure and ARDS using the databases of PubMed,Embase,Scopus and directory of open access joals.In this narrative review,we summarized the pathophysiology and treatment of respiratory distress syndrome following AKI.This review promotes knowledge of the link between kidney and lung with mechanisms,diagnostic biomarkers,and treatment involved ARDS induced by AKI.