

<!-- DFS ActiveDisclosure(SM) XBRL Linkbase Document - http://www.dfsco.com/financial-services/ -->
<!-- Creation Date      : 2019-03-26T17:27:28.7475396+00:00 -->
<!-- Version            : 3.3.6989.14284 -->
<!-- Package ID         : f9c653f968ca43efb3ac33a4d47fff0f -->
<!-- Copyright (c) 2019 Donnelley Financial, LLC. All Rights Reserved. -->
<linkbase xmlns="http://www.xbrl.org/2003/linkbase" xmlns:link="http://www.xbrl.org/2003/linkbase" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.xbrl.org/2003/linkbase http://www.xbrl.org/2003/xbrl-linkbase-2003-12-31.xsd">
  <roleRef roleURI="http://akebia.com/20181231/role/TemplateLink" xlink:href="akba-20181231.xsd#TemplateLink" xlink:type="simple" />
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DocumentDocumentAndEntityInformation" xlink:href="akba-20181231.xsd#Role_DocumentDocumentAndEntityInformation" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DocumentDocumentAndEntityInformation">
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityPublicFloat" xlink:type="locator" xlink:label="dei_EntityPublicFloat" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityCurrentReportingStatus" xlink:type="locator" xlink:label="dei_EntityCurrentReportingStatus" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityVoluntaryFilers" xlink:type="locator" xlink:label="dei_EntityVoluntaryFilers" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityWellKnownSeasonedIssuer" xlink:type="locator" xlink:label="dei_EntityWellKnownSeasonedIssuer" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityCommonStockSharesOutstanding" xlink:type="locator" xlink:label="dei_EntityCommonStockSharesOutstanding" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityShellCompany" xlink:type="locator" xlink:label="dei_EntityShellCompany" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityExTransitionPeriod" xlink:type="locator" xlink:label="dei_EntityExTransitionPeriod" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityEmergingGrowthCompany" xlink:type="locator" xlink:label="dei_EntityEmergingGrowthCompany" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntitySmallBusiness" xlink:type="locator" xlink:label="dei_EntitySmallBusiness" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityFilerCategory" xlink:type="locator" xlink:label="dei_EntityFilerCategory" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_CurrentFiscalYearEndDate" xlink:type="locator" xlink:label="dei_CurrentFiscalYearEndDate" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityCentralIndexKey" xlink:type="locator" xlink:label="dei_EntityCentralIndexKey" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_EntityRegistrantName" xlink:type="locator" xlink:label="dei_EntityRegistrantName" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_TradingSymbol" xlink:type="locator" xlink:label="dei_TradingSymbol" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentFiscalPeriodFocus" xlink:type="locator" xlink:label="dei_DocumentFiscalPeriodFocus" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentFiscalYearFocus" xlink:type="locator" xlink:label="dei_DocumentFiscalYearFocus" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentPeriodEndDate" xlink:type="locator" xlink:label="dei_DocumentPeriodEndDate" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_AmendmentFlag" xlink:type="locator" xlink:label="dei_AmendmentFlag" />
    <loc xlink:href="https://xbrl.sec.gov/dei/2018/dei-2018-01-31.xsd#dei_DocumentType" xlink:type="locator" xlink:label="dei_DocumentType" />
    <loc xlink:href="akba-20181231.xsd#akba_DocumentAndEntityInformationAbstract" xlink:type="locator" xlink:label="akba_DocumentAndEntityInformationAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_DocumentType" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_AmendmentFlag" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_DocumentPeriodEndDate" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_DocumentFiscalYearFocus" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_DocumentFiscalPeriodFocus" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_TradingSymbol" order="10310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityRegistrantName" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityCentralIndexKey" order="10430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_CurrentFiscalYearEndDate" order="10490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityFilerCategory" order="10550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntitySmallBusiness" order="10610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityEmergingGrowthCompany" order="10670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityExTransitionPeriod" order="10730.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityShellCompany" order="10790.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityCommonStockSharesOutstanding" order="10850.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityWellKnownSeasonedIssuer" order="10910.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityVoluntaryFilers" order="10970.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityCurrentReportingStatus" order="11030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_DocumentAndEntityInformationAbstract" xlink:to="dei_EntityPublicFloat" order="11090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedBalanceSheets" xlink:href="akba-20181231.xsd#Role_StatementConsolidatedBalanceSheets" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedBalanceSheets">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquity" xlink:type="locator" xlink:label="us-gaap_LiabilitiesAndStockholdersEquity" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquity" xlink:type="locator" xlink:label="us-gaap_StockholdersEquity" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RetainedEarningsAccumulatedDeficit" xlink:type="locator" xlink:label="us-gaap_RetainedEarningsAccumulatedDeficit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax" xlink:type="locator" xlink:label="us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdditionalPaidInCapitalCommonStock" xlink:type="locator" xlink:label="us-gaap_AdditionalPaidInCapitalCommonStock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockValue" xlink:type="locator" xlink:label="us-gaap_CommonStockValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PreferredStockValue" xlink:type="locator" xlink:label="us-gaap_PreferredStockValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquityAbstract" xlink:type="locator" xlink:label="us-gaap_StockholdersEquityAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommitmentsAndContingencies" xlink:type="locator" xlink:label="us-gaap_CommitmentsAndContingencies" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Liabilities" xlink:type="locator" xlink:label="us-gaap_Liabilities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherLiabilitiesNoncurrent" xlink:type="locator" xlink:label="us-gaap_OtherLiabilitiesNoncurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilities" xlink:type="locator" xlink:label="us-gaap_DeferredTaxLiabilities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiabilityNoncurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiabilityNoncurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredRentCreditNoncurrent" xlink:type="locator" xlink:label="us-gaap_DeferredRentCreditNoncurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesCurrent" xlink:type="locator" xlink:label="us-gaap_LiabilitiesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiabilityCurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiabilityCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LinesOfCreditCurrent" xlink:type="locator" xlink:label="us-gaap_LinesOfCreditCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedLiabilitiesCurrent" xlink:type="locator" xlink:label="us-gaap_AccruedLiabilitiesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableCurrent" xlink:type="locator" xlink:label="us-gaap_AccountsPayableCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesCurrentAbstract" xlink:type="locator" xlink:label="us-gaap_LiabilitiesCurrentAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:type="locator" xlink:label="us-gaap_LiabilitiesAndStockholdersEquityAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Assets" xlink:type="locator" xlink:label="us-gaap_Assets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherAssetsNoncurrent" xlink:type="locator" xlink:label="us-gaap_OtherAssetsNoncurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherIntangibleAssetsNet" xlink:type="locator" xlink:label="us-gaap_OtherIntangibleAssetsNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Goodwill" xlink:type="locator" xlink:label="us-gaap_Goodwill" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentNet" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AssetsCurrent" xlink:type="locator" xlink:label="us-gaap_AssetsCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PrepaidExpenseAndOtherAssetsCurrent" xlink:type="locator" xlink:label="us-gaap_PrepaidExpenseAndOtherAssetsCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableNetCurrent" xlink:type="locator" xlink:label="us-gaap_AccountsReceivableNetCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryNet" xlink:type="locator" xlink:label="us-gaap_InventoryNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AvailableForSaleSecuritiesDebtSecurities" xlink:type="locator" xlink:label="us-gaap_AvailableForSaleSecuritiesDebtSecurities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:type="locator" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AssetsCurrentAbstract" xlink:type="locator" xlink:label="us-gaap_AssetsCurrentAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AssetsAbstract" xlink:type="locator" xlink:label="us-gaap_AssetsAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementOfFinancialPositionAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfFinancialPositionAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_AssetsAbstract" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_AssetsCurrentAbstract" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue" order="10440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_AvailableForSaleSecuritiesDebtSecurities" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_InventoryNet" order="10520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_AccountsReceivableNetCurrent" order="10560.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_PrepaidExpenseAndOtherAssetsCurrent" order="10600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsCurrentAbstract" xlink:to="us-gaap_AssetsCurrent" order="10640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentNet" order="10680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_Goodwill" order="10720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_OtherIntangibleAssetsNet" order="10760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_OtherAssetsNoncurrent" order="10800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AssetsAbstract" xlink:to="us-gaap_Assets" order="10840.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_LiabilitiesAndStockholdersEquityAbstract" order="10880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesCurrentAbstract" order="10960.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_AccountsPayableCurrent" order="11040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_AccruedLiabilitiesCurrent" order="11080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_LinesOfCreditCurrent" order="11120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_ContractWithCustomerLiabilityCurrent" order="11160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesCurrentAbstract" xlink:to="us-gaap_LiabilitiesCurrent" order="11200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_DeferredRentCreditNoncurrent" order="11240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_ContractWithCustomerLiabilityNoncurrent" order="11280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_DeferredTaxLiabilities" order="11320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_OtherLiabilitiesNoncurrent" order="11360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_Liabilities" order="11400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_CommitmentsAndContingencies" order="11440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_StockholdersEquityAbstract" order="11480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_PreferredStockValue" order="11560.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_CommonStockValue" order="11600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_AdditionalPaidInCapitalCommonStock" order="11640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_AccumulatedOtherComprehensiveIncomeLossNetOfTax" order="11680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_RetainedEarningsAccumulatedDeficit" order="11720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StockholdersEquityAbstract" xlink:to="us-gaap_StockholdersEquity" order="11760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LiabilitiesAndStockholdersEquityAbstract" xlink:to="us-gaap_LiabilitiesAndStockholdersEquity" order="11800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedBalanceSheetsParenthetical" xlink:href="akba-20181231.xsd#Role_StatementConsolidatedBalanceSheetsParenthetical" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedBalanceSheetsParenthetical">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesOutstanding" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockSharesIssued" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesIssued" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockSharesAuthorized" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesAuthorized" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockParOrStatedValuePerShare" xlink:type="locator" xlink:label="us-gaap_CommonStockParOrStatedValuePerShare" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PreferredStockSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_PreferredStockSharesOutstanding" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PreferredStockSharesIssued" xlink:type="locator" xlink:label="us-gaap_PreferredStockSharesIssued" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PreferredStockSharesAuthorized" xlink:type="locator" xlink:label="us-gaap_PreferredStockSharesAuthorized" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PreferredStockParOrStatedValuePerShare" xlink:type="locator" xlink:label="us-gaap_PreferredStockParOrStatedValuePerShare" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementOfFinancialPositionAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfFinancialPositionAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_PreferredStockParOrStatedValuePerShare" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_PreferredStockSharesAuthorized" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_PreferredStockSharesIssued" order="10090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_PreferredStockSharesOutstanding" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_CommonStockParOrStatedValuePerShare" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_CommonStockSharesAuthorized" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_CommonStockSharesIssued" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfFinancialPositionAbstract" xlink:to="us-gaap_CommonStockSharesOutstanding" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedStatementsOfOperationsAndComprehensiveLoss" xlink:href="akba-20181231.xsd#Role_StatementConsolidatedStatementsOfOperationsAndComprehensiveLoss" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedStatementsOfOperationsAndComprehensiveLoss">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ComprehensiveIncomeNetOfTax" xlink:type="locator" xlink:label="us-gaap_ComprehensiveIncomeNetOfTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherComprehensiveIncomeUnrealizedHoldingGainLossOnSecuritiesArisingDuringPeriodNetOfTax" xlink:type="locator" xlink:label="us-gaap_OtherComprehensiveIncomeUnrealizedHoldingGainLossOnSecuritiesArisingDuringPeriodNetOfTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ComprehensiveIncomeNetOfTaxAbstract" xlink:type="locator" xlink:label="us-gaap_ComprehensiveIncomeNetOfTaxAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfShareOutstandingBasicAndDiluted" xlink:type="locator" xlink:label="us-gaap_WeightedAverageNumberOfShareOutstandingBasicAndDiluted" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasicAndDiluted" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareBasicAndDiluted" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:type="locator" xlink:label="us-gaap_NetIncomeLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_IncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" xlink:type="locator" xlink:label="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherNonoperatingIncomeExpense" xlink:type="locator" xlink:label="us-gaap_OtherNonoperatingIncomeExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestIncomeExpenseNonoperatingNet" xlink:type="locator" xlink:label="us-gaap_InterestIncomeExpenseNonoperatingNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NonoperatingIncomeExpenseAbstract" xlink:type="locator" xlink:label="us-gaap_NonoperatingIncomeExpenseAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingIncomeLoss" xlink:type="locator" xlink:label="us-gaap_OperatingIncomeLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingExpenses" xlink:type="locator" xlink:label="us-gaap_OperatingExpenses" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseExpense" xlink:type="locator" xlink:label="akba_LicenseExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SellingGeneralAndAdministrativeExpense" xlink:type="locator" xlink:label="us-gaap_SellingGeneralAndAdministrativeExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentExpense" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingExpensesAbstract" xlink:type="locator" xlink:label="us-gaap_OperatingExpensesAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CostOfRevenue" xlink:type="locator" xlink:label="us-gaap_CostOfRevenue" />
    <loc xlink:href="akba-20181231.xsd#akba_AmortizationOfIntangibleAssetsProduct" xlink:type="locator" xlink:label="akba_AmortizationOfIntangibleAssetsProduct" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfCostGoodOrServiceExtensibleList" xlink:type="locator" xlink:label="us-gaap_TypeOfCostGoodOrServiceExtensibleList" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CostOfGoodsAndServicesSold" xlink:type="locator" xlink:label="us-gaap_CostOfGoodsAndServicesSold" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CostOfRevenueAbstract" xlink:type="locator" xlink:label="us-gaap_CostOfRevenueAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenuesAbstract" xlink:type="locator" xlink:label="us-gaap_RevenuesAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseCollaborationAndOtherRevenueMember" xlink:type="locator" xlink:label="akba_LicenseCollaborationAndOtherRevenueMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProductMember" xlink:type="locator" xlink:label="us-gaap_ProductMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:type="locator" xlink:label="srt_ProductsAndServicesDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:type="locator" xlink:label="srt_ProductOrServiceAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeStatementAbstract" xlink:type="locator" xlink:label="us-gaap_IncomeStatementAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementAbstract" xlink:to="us-gaap_StatementTable" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="srt_ProductOrServiceAxis" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_ProductMember" order="10230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="akba_LicenseCollaborationAndOtherRevenueMember" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_RevenuesAbstract" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenuesAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" order="10400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CostOfRevenueAbstract" order="10580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostOfRevenueAbstract" xlink:to="us-gaap_CostOfGoodsAndServicesSold" order="10700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostOfRevenueAbstract" xlink:to="us-gaap_TypeOfCostGoodOrServiceExtensibleList" order="10760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostOfRevenueAbstract" xlink:to="akba_AmortizationOfIntangibleAssetsProduct" order="10820.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CostOfRevenueAbstract" xlink:to="us-gaap_CostOfRevenue" order="10880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingExpensesAbstract" order="10940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="us-gaap_ResearchAndDevelopmentExpense" order="11060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="us-gaap_SellingGeneralAndAdministrativeExpense" order="11120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="akba_LicenseExpense" order="11180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OperatingExpensesAbstract" xlink:to="us-gaap_OperatingExpenses" order="11240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OperatingIncomeLoss" order="11300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NonoperatingIncomeExpenseAbstract" order="11360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonoperatingIncomeExpenseAbstract" xlink:to="us-gaap_InterestIncomeExpenseNonoperatingNet" order="11480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonoperatingIncomeExpenseAbstract" xlink:to="us-gaap_OtherNonoperatingIncomeExpense" order="11540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeLossFromContinuingOperationsBeforeIncomeTaxesExtraordinaryItemsNoncontrollingInterest" order="11600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="11660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetIncomeLoss" order="11720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_EarningsPerShareBasicAndDiluted" order="11780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_WeightedAverageNumberOfShareOutstandingBasicAndDiluted" order="11840.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ComprehensiveIncomeNetOfTaxAbstract" order="11900.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ComprehensiveIncomeNetOfTaxAbstract" xlink:to="us-gaap_NetIncomeLoss" order="12020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ComprehensiveIncomeNetOfTaxAbstract" xlink:to="us-gaap_OtherComprehensiveIncomeUnrealizedHoldingGainLossOnSecuritiesArisingDuringPeriodNetOfTax" order="12080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ComprehensiveIncomeNetOfTaxAbstract" xlink:to="us-gaap_ComprehensiveIncomeNetOfTax" order="12140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedStatementsOfStockholdersEquity" xlink:href="akba-20181231.xsd#Role_StatementConsolidatedStatementsOfStockholdersEquity" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedStatementsOfStockholdersEquity">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesOutstanding_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquity" xlink:type="locator" xlink:label="us-gaap_StockholdersEquity_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:type="locator" xlink:label="us-gaap_NetIncomeLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TreasuryStockRetiredCostMethodAmount" xlink:type="locator" xlink:label="us-gaap_TreasuryStockRetiredCostMethodAmount" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherComprehensiveIncomeLossAvailableForSaleSecuritiesAdjustmentNetOfTax" xlink:type="locator" xlink:label="us-gaap_OtherComprehensiveIncomeLossAvailableForSaleSecuritiesAdjustmentNetOfTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalWarrantIssued" xlink:type="locator" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalWarrantIssued" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardNetOfForfeitures" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardNetOfForfeitures" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" xlink:type="locator" xlink:label="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueEmployeeStockPurchasePlan" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodValueEmployeeStockPurchasePlan" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesNewIssues" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesNewIssues" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueNewIssues" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodValueNewIssues" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesConversionOfConvertibleSecurities" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesConversionOfConvertibleSecurities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueConversionOfConvertibleSecurities" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodValueConversionOfConvertibleSecurities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesAcquisitions" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesAcquisitions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueAcquisitions" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodValueAcquisitions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesOutstanding" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquity" xlink:type="locator" xlink:label="us-gaap_StockholdersEquity" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RetainedEarningsMember" xlink:type="locator" xlink:label="us-gaap_RetainedEarningsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccumulatedNetUnrealizedInvestmentGainLossMember" xlink:type="locator" xlink:label="us-gaap_AccumulatedNetUnrealizedInvestmentGainLossMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TreasuryStockMember" xlink:type="locator" xlink:label="us-gaap_TreasuryStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdditionalPaidInCapitalMember" xlink:type="locator" xlink:label="us-gaap_AdditionalPaidInCapitalMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockMember" xlink:type="locator" xlink:label="us-gaap_CommonStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementOfStockholdersEquityAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfStockholdersEquityAbstract" xlink:to="us-gaap_StatementTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_AdditionalPaidInCapitalMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_TreasuryStockMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_AccumulatedNetUnrealizedInvestmentGainLossMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_RetainedEarningsMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquity" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesOutstanding" order="10230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueAcquisitions" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesAcquisitions" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueConversionOfConvertibleSecurities" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesConversionOfConvertibleSecurities" order="10550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueNewIssues" order="10690.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesNewIssues" order="10710.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueEmployeeStockPurchasePlan" order="10850.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesEmployeeStockPurchasePlans" order="10870.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueRestrictedStockAwardForfeitures" order="11010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardForfeited" order="11030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueStockOptionsExercised" order="11170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" order="11190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalSharebasedCompensationRequisiteServicePeriodRecognitionValue" order="11330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesRestrictedStockAwardNetOfForfeitures" order="11490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_AdjustmentsToAdditionalPaidInCapitalWarrantIssued" order="11650.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_OtherComprehensiveIncomeLossAvailableForSaleSecuritiesAdjustmentNetOfTax" order="11810.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_TreasuryStockRetiredCostMethodAmount" order="11970.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_NetIncomeLoss" order="12130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_StockholdersEquity_li0l2" order="12290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_CommonStockSharesOutstanding_li0l2" order="12310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedStatementsOfStockholdersEquityParenthetical" xlink:href="akba-20181231.xsd#Role_StatementConsolidatedStatementsOfStockholdersEquityParenthetical" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedStatementsOfStockholdersEquityParenthetical">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TreasuryStockSharesRetired" xlink:type="locator" xlink:label="us-gaap_TreasuryStockSharesRetired" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementOfStockholdersEquityAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfStockholdersEquityAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfStockholdersEquityAbstract" xlink:to="us-gaap_TreasuryStockSharesRetired" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedStatementsOfCashFlows" xlink:href="akba-20181231.xsd#Role_StatementConsolidatedStatementsOfCashFlows" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/StatementConsolidatedStatementsOfCashFlows">
    <loc xlink:href="akba-20181231.xsd#akba_DeferredFollowOnOfferingIssuanceCosts" xlink:type="locator" xlink:label="akba_DeferredFollowOnOfferingIssuanceCosts" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssued1" xlink:type="locator" xlink:label="us-gaap_StockIssued1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:type="locator" xlink:label="us-gaap_NoncashInvestingAndFinancingItemsAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivities" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RepaymentsOfLongTermCapitalLeaseObligations" xlink:type="locator" xlink:label="us-gaap_RepaymentsOfLongTermCapitalLeaseObligations" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromStockOptionsExercised" xlink:type="locator" xlink:label="us-gaap_ProceedsFromStockOptionsExercised" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromStockPlans" xlink:type="locator" xlink:label="us-gaap_ProceedsFromStockPlans" />
    <loc xlink:href="akba-20181231.xsd#akba_ProceedsFromIssuanceOfCommonStockNetOfIssuanceCosts" xlink:type="locator" xlink:label="akba_ProceedsFromIssuanceOfCommonStockNetOfIssuanceCosts" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivities" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PaymentsToAcquireAvailableForSaleSecuritiesDebt" xlink:type="locator" xlink:label="us-gaap_PaymentsToAcquireAvailableForSaleSecuritiesDebt" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromSaleOfAvailableForSaleSecuritiesDebt" xlink:type="locator" xlink:label="us-gaap_ProceedsFromSaleOfAvailableForSaleSecuritiesDebt" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromMaturitiesPrepaymentsAndCallsOfAvailableForSaleSecurities" xlink:type="locator" xlink:label="us-gaap_ProceedsFromMaturitiesPrepaymentsAndCallsOfAvailableForSaleSecurities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PaymentsToAcquirePropertyPlantAndEquipment" xlink:type="locator" xlink:label="us-gaap_PaymentsToAcquirePropertyPlantAndEquipment" />
    <loc xlink:href="akba-20181231.xsd#akba_PaymentsToAcquireBusinessesNetOfAcquiredCashAndRestrictedCash" xlink:type="locator" xlink:label="akba_PaymentsToAcquireBusinessesNetOfAcquiredCashAndRestrictedCash" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivities" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivities" />
    <loc xlink:href="akba-20181231.xsd#akba_IncreaseDecreaseInDeferredRent" xlink:type="locator" xlink:label="akba_IncreaseDecreaseInDeferredRent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInContractWithCustomerLiability" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInContractWithCustomerLiability" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccruedLiabilities" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInAccruedLiabilities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsPayable" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInAccountsPayable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOtherNoncurrentAssets" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInInventories" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInInventories" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInAccountsReceivable" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInAccountsReceivable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueAdjustmentOfWarrants" xlink:type="locator" xlink:label="us-gaap_FairValueAdjustmentOfWarrants" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_IncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensation" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensation" />
    <loc xlink:href="akba-20181231.xsd#akba_FairValueWriteUpOfInventorySold" xlink:type="locator" xlink:label="akba_FairValueWriteUpOfInventorySold" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GainLossOnDispositionOfAssets" xlink:type="locator" xlink:label="us-gaap_GainLossOnDispositionOfAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NoncashMergerRelatedCosts" xlink:type="locator" xlink:label="us-gaap_NoncashMergerRelatedCosts" />
    <loc xlink:href="akba-20181231.xsd#akba_NoncashInterestExpense" xlink:type="locator" xlink:label="akba_NoncashInterestExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccretionAmortizationOfDiscountsAndPremiumsInvestments" xlink:type="locator" xlink:label="us-gaap_AccretionAmortizationOfDiscountsAndPremiumsInvestments" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AmortizationOfIntangibleAssets" xlink:type="locator" xlink:label="us-gaap_AmortizationOfIntangibleAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DepreciationDepletionAndAmortization" xlink:type="locator" xlink:label="us-gaap_DepreciationDepletionAndAmortization" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="locator" xlink:label="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:type="locator" xlink:label="us-gaap_NetIncomeLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="locator" xlink:label="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementOfCashFlowsAbstract" xlink:type="locator" xlink:label="us-gaap_StatementOfCashFlowsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_NetIncomeLoss" order="10440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_DepreciationDepletionAndAmortization" order="10620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AmortizationOfIntangibleAssets" order="10680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_AccretionAmortizationOfDiscountsAndPremiumsInvestments" order="10740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="akba_NoncashInterestExpense" order="10800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_NoncashMergerRelatedCosts" order="10860.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_GainLossOnDispositionOfAssets" order="10920.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="akba_FairValueWriteUpOfInventorySold" order="10980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_ShareBasedCompensation" order="11040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="11100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_FairValueAdjustmentOfWarrants" order="11160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" order="11220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInAccountsReceivable" order="11340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInInventories" order="11400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInPrepaidDeferredExpenseAndOtherAssets" order="11460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInOtherNoncurrentAssets" order="11520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInAccountsPayable" order="11580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInAccruedLiabilities" order="11640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="us-gaap_IncreaseDecreaseInContractWithCustomerLiability" order="11700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncreaseDecreaseInOperatingCapitalAbstract" xlink:to="akba_IncreaseDecreaseInDeferredRent" order="11760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInOperatingActivities" order="11820.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" order="11880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="akba_PaymentsToAcquireBusinessesNetOfAcquiredCashAndRestrictedCash" order="12000.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquirePropertyPlantAndEquipment" order="12060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromMaturitiesPrepaymentsAndCallsOfAvailableForSaleSecurities" order="12120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromSaleOfAvailableForSaleSecuritiesDebt" order="12180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_PaymentsToAcquireAvailableForSaleSecuritiesDebt" order="12240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInInvestingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInInvestingActivities" order="12300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" order="12360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="akba_ProceedsFromIssuanceOfCommonStockNetOfIssuanceCosts" order="12480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromStockPlans" order="12540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_ProceedsFromStockOptionsExercised" order="12600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_RepaymentsOfLongTermCapitalLeaseObligations" order="12660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NetCashProvidedByUsedInFinancingActivitiesAbstract" xlink:to="us-gaap_NetCashProvidedByUsedInFinancingActivities" order="12720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalentsPeriodIncreaseDecreaseIncludingExchangeRateEffect" order="12780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" order="12840.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_li0l2" order="12900.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementOfCashFlowsAbstract" xlink:to="us-gaap_NoncashInvestingAndFinancingItemsAbstract" order="12960.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:to="us-gaap_StockIssued1" order="13080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NoncashInvestingAndFinancingItemsAbstract" xlink:to="akba_DeferredFollowOnOfferingIssuanceCosts" order="13140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureNatureOfOrganizationAndOperations" xlink:href="akba-20181231.xsd#Role_DisclosureNatureOfOrganizationAndOperations" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureNatureOfOrganizationAndOperations">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NatureOfOperations" xlink:type="locator" xlink:label="us-gaap_NatureOfOperations" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_NatureOfOperations" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPolicies" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPolicies" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPolicies">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SignificantAccountingPoliciesTextBlock" xlink:type="locator" xlink:label="us-gaap_SignificantAccountingPoliciesTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_SignificantAccountingPoliciesTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureProductRevenueNet" xlink:href="akba-20181231.xsd#Role_DisclosureProductRevenueNet" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureProductRevenueNet">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerTextBlock" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerAbstract" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueFromContractWithCustomerAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreements" xlink:href="akba-20181231.xsd#Role_DisclosureLicenseCollaborationAndOtherSignificantAgreements" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreements">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CollaborativeArrangementDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_CollaborativeArrangementDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_CollaborativeArrangementDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombination" xlink:href="akba-20181231.xsd#Role_DisclosureBusinessCombination" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombination">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_BusinessCombinationDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecurities" xlink:href="akba-20181231.xsd#Role_DisclosureAvailableForSaleSecurities" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecurities">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:type="locator" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_InvestmentsInDebtAndMarketableEquitySecuritiesAndCertainTradingAssetsDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureFairValueOfFinancialInstruments" xlink:href="akba-20181231.xsd#Role_DisclosureFairValueOfFinancialInstruments" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureFairValueOfFinancialInstruments">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueDisclosuresTextBlock" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueDisclosuresAbstract" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_FairValueDisclosuresTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureInventory" xlink:href="akba-20181231.xsd#Role_DisclosureInventory" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureInventory">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_InventoryDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_InventoryDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InventoryDisclosureAbstract" xlink:to="us-gaap_InventoryDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwill" xlink:href="akba-20181231.xsd#Role_DisclosureIntangibleAssetsAndGoodwill" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwill">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_GoodwillAndIntangibleAssetsDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureAccruedExpenses" xlink:href="akba-20181231.xsd#Role_DisclosureAccruedExpenses" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureAccruedExpenses">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PayablesAndAccrualsAbstract" xlink:type="locator" xlink:label="us-gaap_PayablesAndAccrualsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccountsPayableAndAccruedLiabilitiesDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureDebt" xlink:href="akba-20181231.xsd#Role_DisclosureDebt" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureDebt">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_DebtDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureWarrant" xlink:href="akba-20181231.xsd#Role_DisclosureWarrant" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureWarrant">
    <loc xlink:href="akba-20181231.xsd#akba_WarrantDisclosureTextBlock" xlink:type="locator" xlink:label="akba_WarrantDisclosureTextBlock" />
    <loc xlink:href="akba-20181231.xsd#akba_WarrantDisclosureAbstract" xlink:type="locator" xlink:label="akba_WarrantDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_WarrantDisclosureAbstract" xlink:to="akba_WarrantDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquity" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquity" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquity">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquityNoteDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_StockholdersEquityNoteDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityAbstract" xlink:type="locator" xlink:label="us-gaap_EquityAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityAbstract" xlink:to="us-gaap_StockholdersEquityNoteDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxes" xlink:href="akba-20181231.xsd#Role_DisclosureIncomeTaxes" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxes">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_IncomeTaxDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_IncomeTaxDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_IncomeTaxDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureEmployeeRetirementPlan" xlink:href="akba-20181231.xsd#Role_DisclosureEmployeeRetirementPlan" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureEmployeeRetirementPlan">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:to="us-gaap_PensionAndOtherPostretirementBenefitsDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureCommitmentsAndContingencies" xlink:href="akba-20181231.xsd#Role_DisclosureCommitmentsAndContingencies" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureCommitmentsAndContingencies">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" xlink:type="locator" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_CommitmentsAndContingenciesDisclosureTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureNetLossPerShare" xlink:href="akba-20181231.xsd#Role_DisclosureNetLossPerShare" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureNetLossPerShare">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareTextBlock" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_EarningsPerShareTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureQuarterlyResultsUnaudited" xlink:href="akba-20181231.xsd#Role_DisclosureQuarterlyResultsUnaudited" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureQuarterlyResultsUnaudited">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationTextBlock" xlink:type="locator" xlink:label="us-gaap_QuarterlyFinancialInformationTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_QuarterlyFinancialInformationTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesPolicies" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesPolicies" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesPolicies">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerSharePolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_EarningsPerSharePolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_IncomeTaxPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdvertisingCostsPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_AdvertisingCostsPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentExpensePolicy" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentExpensePolicy" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueOfFinancialInstrumentsPolicy" xlink:type="locator" xlink:label="us-gaap_FairValueOfFinancialInstrumentsPolicy" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsGoodwillPolicy" xlink:type="locator" xlink:label="us-gaap_GoodwillAndIntangibleAssetsGoodwillPolicy" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IntangibleAssetsFiniteLivedPolicy" xlink:type="locator" xlink:label="us-gaap_IntangibleAssetsFiniteLivedPolicy" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsPolicy" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsPolicy" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueRecognitionPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_RevenueRecognitionPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_InventoryPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskCreditRisk" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskCreditRisk" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ReceivablesPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_ReceivablesPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_InvestmentPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_CashAndCashEquivalentsPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_UseOfEstimates" xlink:type="locator" xlink:label="us-gaap_UseOfEstimates" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DerivativesPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_DerivativesPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SegmentReportingPolicyPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_SegmentReportingPolicyPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BasisOfAccountingPolicyPolicyTextBlock" xlink:type="locator" xlink:label="us-gaap_BasisOfAccountingPolicyPolicyTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_BasisOfAccountingPolicyPolicyTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_NewAccountingPronouncementsPolicyPolicyTextBlock" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_SegmentReportingPolicyPolicyTextBlock" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_DerivativesPolicyTextBlock" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_UseOfEstimates" order="10090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_CashAndCashEquivalentsPolicyTextBlock" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_InvestmentPolicyTextBlock" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ReceivablesPolicyTextBlock" order="10150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ConcentrationRiskCreditRisk" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_PropertyPlantAndEquipmentPolicyTextBlock" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_InventoryPolicyTextBlock" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_RevenueRecognitionPolicyTextBlock" order="10230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_BusinessCombinationsPolicy" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_IntangibleAssetsFiniteLivedPolicy" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_GoodwillAndIntangibleAssetsGoodwillPolicy" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_FairValueOfFinancialInstrumentsPolicy" order="10310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ResearchAndDevelopmentExpensePolicy" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_AdvertisingCostsPolicyTextBlock" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_IncomeTaxPolicyTextBlock" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ShareBasedCompensationOptionAndIncentivePlansPolicy" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_EarningsPerSharePolicyTextBlock" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesTables" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTextBlock" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock" xlink:type="locator" xlink:label="us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock" />
    <loc xlink:href="akba-20181231.xsd#akba_ReconciliationOfCashCashEquivalentsAndRestrictedCashTableTextBlock" xlink:type="locator" xlink:label="akba_ReconciliationOfCashCashEquivalentsAndRestrictedCashTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfNewAccountingPronouncementsAndChangesInAccountingPrinciplesTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfNewAccountingPronouncementsAndChangesInAccountingPrinciplesTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingStandardsUpdate201409Member" xlink:type="locator" xlink:label="us-gaap_AccountingStandardsUpdate201409Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfAdoptionMember" xlink:type="locator" xlink:label="us-gaap_TypeOfAdoptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:type="locator" xlink:label="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_StatementTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:to="us-gaap_TypeOfAdoptionMember" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfAdoptionMember" xlink:to="us-gaap_AccountingStandardsUpdate201409Member" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ScheduleOfNewAccountingPronouncementsAndChangesInAccountingPrinciplesTextBlock" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="akba_ReconciliationOfCashCashEquivalentsAndRestrictedCashTableTextBlock" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_SchedulesOfConcentrationOfRiskByRiskFactorTextBlock" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentTextBlock" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureProductRevenueNetTables" xlink:href="akba-20181231.xsd#Role_DisclosureProductRevenueNetTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureProductRevenueNetTables">
    <loc xlink:href="akba-20181231.xsd#akba_ScheduleOfProductRevenueAllowanceAndReserveCategoriesTableTextBlock" xlink:type="locator" xlink:label="akba_ScheduleOfProductRevenueAllowanceAndReserveCategoriesTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerAbstract" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueFromContractWithCustomerAbstract" xlink:to="akba_ScheduleOfProductRevenueAllowanceAndReserveCategoriesTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsTables" xlink:href="akba-20181231.xsd#Role_DisclosureLicenseCollaborationAndOtherSignificantAgreementsTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsTables">
    <loc xlink:href="akba-20181231.xsd#akba_ScheduleOfRevenueRecognizedResultingFromChangesInContractAssetAndContractLiabilityTableTextBlock" xlink:type="locator" xlink:label="akba_ScheduleOfRevenueRecognizedResultingFromChangesInContractAssetAndContractLiabilityTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerAssetAndLiabilityTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerAssetAndLiabilityTableTextBlock" />
    <loc xlink:href="akba-20181231.xsd#akba_DeferredRevenueRecognitionTableTextBlock" xlink:type="locator" xlink:label="akba_DeferredRevenueRecognitionTableTextBlock" />
    <loc xlink:href="akba-20181231.xsd#akba_CollaborativeArrangementRevenueRecognitionTableTextBlock" xlink:type="locator" xlink:label="akba_CollaborativeArrangementRevenueRecognitionTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="akba_CollaborativeArrangementRevenueRecognitionTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="akba_DeferredRevenueRecognitionTableTextBlock" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_ContractWithCustomerAssetAndLiabilityTableTextBlock" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="akba_ScheduleOfRevenueRecognizedResultingFromChangesInContractAssetAndContractLiabilityTableTextBlock" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationTables" xlink:href="akba-20181231.xsd#Role_DisclosureBusinessCombinationTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionProFormaInformationTextBlock" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionProFormaInformationTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfRecognizedIdentifiedAssetsAcquiredAndLiabilitiesAssumedTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfRecognizedIdentifiedAssetsAcquiredAndLiabilitiesAssumedTableTextBlock" />
    <loc xlink:href="akba-20181231.xsd#akba_ScheduleOfBusinessAcquisitionsTransactionPriceTextBlock" xlink:type="locator" xlink:label="akba_ScheduleOfBusinessAcquisitionsTransactionPriceTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="akba_ScheduleOfBusinessAcquisitionsTransactionPriceTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfRecognizedIdentifiedAssetsAcquiredAndLiabilitiesAssumedTableTextBlock" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_BusinessAcquisitionProFormaInformationTextBlock" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesTables" xlink:href="akba-20181231.xsd#Role_DisclosureAvailableForSaleSecuritiesTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionFairValueTableTextBlock" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionFairValueTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock" xlink:type="locator" xlink:label="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleTableTextBlock" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:type="locator" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_InvestmentsClassifiedByContractualMaturityDateTableTextBlock" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionFairValueTableTextBlock" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsTables" xlink:href="akba-20181231.xsd#Role_DisclosureFairValueOfFinancialInstrumentsTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueAssetsMeasuredOnRecurringBasisTextBlock" xlink:type="locator" xlink:label="us-gaap_FairValueAssetsMeasuredOnRecurringBasisTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueDisclosuresAbstract" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_FairValueAssetsMeasuredOnRecurringBasisTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureInventoryTables" xlink:href="akba-20181231.xsd#Role_DisclosureInventoryTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureInventoryTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfInventoryCurrentTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfInventoryCurrentTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_InventoryDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InventoryDisclosureAbstract" xlink:to="us-gaap_ScheduleOfInventoryCurrentTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwillTables" xlink:href="akba-20181231.xsd#Role_DisclosureIntangibleAssetsAndGoodwillTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwillTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseTableTextBlock" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureAccruedExpensesTables" xlink:href="akba-20181231.xsd#Role_DisclosureAccruedExpensesTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureAccruedExpensesTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAccruedLiabilitiesTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfAccruedLiabilitiesTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PayablesAndAccrualsAbstract" xlink:type="locator" xlink:label="us-gaap_PayablesAndAccrualsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_ScheduleOfAccruedLiabilitiesTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityTables" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquityTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityTables">
    <loc xlink:href="akba-20181231.xsd#akba_ScheduleOfCompensationCostForShareBasedPaymentArrangementsAllocationOfShareBasedCompensationCostsByAwardTableTextBlock" xlink:type="locator" xlink:label="akba_ScheduleOfCompensationCostForShareBasedPaymentArrangementsAllocationOfShareBasedCompensationCostsByAwardTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfNonvestedRestrictedStockUnitsActivityTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfNonvestedRestrictedStockUnitsActivityTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfNonvestedPerformanceBasedUnitsActivityTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfNonvestedPerformanceBasedUnitsActivityTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedPaymentAwardStockOptionsValuationAssumptionsTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfShareBasedPaymentAwardStockOptionsValuationAssumptionsTableTextBlock" />
    <loc xlink:href="akba-20181231.xsd#akba_CommonStockReservedForFutureIssuanceTableTextBlock" xlink:type="locator" xlink:label="akba_CommonStockReservedForFutureIssuanceTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementLineItems" xlink:type="locator" xlink:label="us-gaap_StatementLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockUnitsRSUMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementTable" xlink:type="locator" xlink:label="us-gaap_StatementTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityAbstract" xlink:type="locator" xlink:label="us-gaap_EquityAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityAbstract" xlink:to="us-gaap_StatementTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockUnitsRSUMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementTable" xlink:to="us-gaap_StatementLineItems" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="akba_CommonStockReservedForFutureIssuanceTableTextBlock" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ScheduleOfShareBasedPaymentAwardStockOptionsValuationAssumptionsTableTextBlock" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ScheduleOfShareBasedCompensationStockOptionsActivityTableTextBlock" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ScheduleOfNonvestedPerformanceBasedUnitsActivityTableTextBlock" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ScheduleOfNonvestedRestrictedStockUnitsActivityTableTextBlock" order="10400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTextBlock" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementLineItems" xlink:to="akba_ScheduleOfCompensationCostForShareBasedPaymentArrangementsAllocationOfShareBasedCompensationCostsByAwardTableTextBlock" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesTables" xlink:href="akba-20181231.xsd#Role_DisclosureIncomeTaxesTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_IncomeTaxDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_ScheduleOfComponentsOfIncomeTaxExpenseBenefitTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_ScheduleOfEffectiveIncomeTaxRateReconciliationTableTextBlock" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_ScheduleOfDeferredTaxAssetsAndLiabilitiesTableTextBlock" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureCommitmentsAndContingenciesTables" xlink:href="akba-20181231.xsd#Role_DisclosureCommitmentsAndContingenciesTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureCommitmentsAndContingenciesTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_ScheduleOfFutureMinimumRentalPaymentsForOperatingLeasesTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureNetLossPerShareTables" xlink:href="akba-20181231.xsd#Role_DisclosureNetLossPerShareTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureNetLossPerShareTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_ScheduleOfAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureQuarterlyResultsUnauditedTables" xlink:href="akba-20181231.xsd#Role_DisclosureQuarterlyResultsUnauditedTables" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureQuarterlyResultsUnauditedTables">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock" xlink:type="locator" xlink:label="us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="us-gaap_ScheduleOfQuarterlyFinancialInformationTableTextBlock" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureNatureOfOrganizationAndOperationsAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureNatureOfOrganizationAndOperationsAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureNatureOfOrganizationAndOperationsAdditionalInformationDetails">
    <loc xlink:href="akba-20181231.xsd#akba_OperatingPlanSufficientlyFundedByCashResourcesPeriod" xlink:type="locator" xlink:label="akba_OperatingPlanSufficientlyFundedByCashResourcesPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromLicenseFeesReceived" xlink:type="locator" xlink:label="us-gaap_ProceedsFromLicenseFeesReceived" />
    <loc xlink:href="akba-20181231.xsd#akba_MinimumCommittedAmountInCostShareFundingAndLicensePaymentsUnderCollaborationAgreements" xlink:type="locator" xlink:label="akba_MinimumCommittedAmountInCostShareFundingAndLicensePaymentsUnderCollaborationAgreements" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesNewIssues" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesNewIssues" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodValueNewIssues" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodValueNewIssues" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromIssuanceOfCommonStock" xlink:type="locator" xlink:label="us-gaap_ProceedsFromIssuanceOfCommonStock" />
    <loc xlink:href="akba-20181231.xsd#akba_CollaborativeArrangementsCostSharingPayments" xlink:type="locator" xlink:label="akba_CollaborativeArrangementsCostSharingPayments" />
    <loc xlink:href="akba-20181231.xsd#akba_PaymentReceivedForLicenseAgreementReimbursementOfPreviouslyCostsIncurred" xlink:type="locator" xlink:label="akba_PaymentReceivedForLicenseAgreementReimbursementOfPreviouslyCostsIncurred" />
    <loc xlink:href="akba-20181231.xsd#akba_RoyaltyPaymentPercentage" xlink:type="locator" xlink:label="akba_RoyaltyPaymentPercentage" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialPaymentForAchievementOfSpecifiedDevelopmentAndRegulatoryMilestones" xlink:type="locator" xlink:label="akba_PotentialPaymentForAchievementOfSpecifiedDevelopmentAndRegulatoryMilestones" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialPaymentForAchievementOfSpecifiedCommercialMilestones" xlink:type="locator" xlink:label="akba_PotentialPaymentForAchievementOfSpecifiedCommercialMilestones" />
    <loc xlink:href="akba-20181231.xsd#akba_UpfrontCashPaymentReceived" xlink:type="locator" xlink:label="akba_UpfrontCashPaymentReceived" />
    <loc xlink:href="akba-20181231.xsd#akba_MilestonePaymentReceived" xlink:type="locator" xlink:label="akba_MilestonePaymentReceived" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CollaborativeArrangementRightsAndObligations" xlink:type="locator" xlink:label="us-gaap_CollaborativeArrangementRightsAndObligations" />
    <loc xlink:href="akba-20181231.xsd#akba_NumberOfEnrolledSubjects" xlink:type="locator" xlink:label="akba_NumberOfEnrolledSubjects" />
    <loc xlink:href="akba-20181231.xsd#akba_NumberOfPatients" xlink:type="locator" xlink:label="akba_NumberOfPatients" />
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationEquityCancelledAndConvertedNumberOfSharesIssued" xlink:type="locator" xlink:label="akba_BusinessCombinationEquityCancelledAndConvertedNumberOfSharesIssued" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquityNoteStockSplitConversionRatio1" xlink:type="locator" xlink:label="us-gaap_StockholdersEquityNoteStockSplitConversionRatio1" />
    <loc xlink:href="akba-20181231.xsd#akba_NatureOfOrganizationAndOperationsLineItems" xlink:type="locator" xlink:label="akba_NatureOfOrganizationAndOperationsLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseAgreementMember" xlink:type="locator" xlink:label="akba_LicenseAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_OtsukaPharmaceuticalCompanyLimitedAndMitsubishiTanabePharmaCorporationMember" xlink:type="locator" xlink:label="akba_OtsukaPharmaceuticalCompanyLimitedAndMitsubishiTanabePharmaCorporationMember" />
    <loc xlink:href="akba-20181231.xsd#akba_ViforPharmaMember" xlink:type="locator" xlink:label="akba_ViforPharmaMember" />
    <loc xlink:href="akba-20181231.xsd#akba_CantorFitzgeraldAndCompanyMember" xlink:type="locator" xlink:label="akba_CantorFitzgeraldAndCompanyMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RelatedPartyTransactionDomain" xlink:type="locator" xlink:label="us-gaap_RelatedPartyTransactionDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RelatedPartyTransactionAxis" xlink:type="locator" xlink:label="us-gaap_RelatedPartyTransactionAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockMember" xlink:type="locator" xlink:label="us-gaap_CommonStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_FollowOnPublicOfferingMember" xlink:type="locator" xlink:label="akba_FollowOnPublicOfferingMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SaleOfStockNameOfTransactionDomain" xlink:type="locator" xlink:label="us-gaap_SaleOfStockNameOfTransactionDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsidiarySaleOfStockAxis" xlink:type="locator" xlink:label="us-gaap_SubsidiarySaleOfStockAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeCollaborationAndLicenseAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeCollaborationAndLicenseAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_OtsukaPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_OtsukaPharmaceuticalCompanyLimitedMember" />
    <loc xlink:href="akba-20181231.xsd#akba_GlobalDevelopmentPlanMember" xlink:type="locator" xlink:label="akba_GlobalDevelopmentPlanMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialCommercialMilestonePaymentsMember" xlink:type="locator" xlink:label="akba_PotentialCommercialMilestonePaymentsMember" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialDevelopmentAndCommercializationMilestonesMember" xlink:type="locator" xlink:label="akba_PotentialDevelopmentAndCommercializationMilestonesMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeCollaborationAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeCollaborationAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_CommercialMilestonePaymentsMember" xlink:type="locator" xlink:label="akba_CommercialMilestonePaymentsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerBasisOfPricingDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerBasisOfPricingAxis" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerBasisOfPricingAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_MitsubishiTanabePharmaCorporationMember" xlink:type="locator" xlink:label="akba_MitsubishiTanabePharmaCorporationMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RepurchaseAgreementCounterpartyNameDomain" xlink:type="locator" xlink:label="srt_RepurchaseAgreementCounterpartyNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_CounterpartyNameAxis" xlink:type="locator" xlink:label="srt_CounterpartyNameAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioForecastMember" xlink:type="locator" xlink:label="us-gaap_ScenarioForecastMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioUnspecifiedDomain" xlink:type="locator" xlink:label="us-gaap_ScenarioUnspecifiedDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementScenarioAxis" xlink:type="locator" xlink:label="us-gaap_StatementScenarioAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsequentEventMember" xlink:type="locator" xlink:label="us-gaap_SubsequentEventMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsequentEventTypeDomain" xlink:type="locator" xlink:label="us-gaap_SubsequentEventTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsequentEventTypeAxis" xlink:type="locator" xlink:label="us-gaap_SubsequentEventTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_SmallerInnovateMember" xlink:type="locator" xlink:label="akba_SmallerInnovateMember" />
    <loc xlink:href="akba-20181231.xsd#akba_LargerInnovateMember" xlink:type="locator" xlink:label="akba_LargerInnovateMember" />
    <loc xlink:href="akba-20181231.xsd#akba_ProtectAndInnovateMember" xlink:type="locator" xlink:label="akba_ProtectAndInnovateMember" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAxis" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_MergerAgreementMember" xlink:type="locator" xlink:label="akba_MergerAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:type="locator" xlink:label="us-gaap_ArrangementsAndNonarrangementTransactionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfArrangementAxis" xlink:type="locator" xlink:label="us-gaap_TypeOfArrangementAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockOptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockUnitsRSUMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_NatureOfOrganizationAndOperationsTable" xlink:type="locator" xlink:label="akba_NatureOfOrganizationAndOperationsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="akba_NatureOfOrganizationAndOperationsTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockUnitsRSUMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_TypeOfArrangementAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfArrangementAxis" xlink:to="us-gaap_ArrangementsAndNonarrangementTransactionsMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_MergerAgreementMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_BusinessAcquisitionAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_ProtectAndInnovateMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_LargerInnovateMember" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_SmallerInnovateMember" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_SubsequentEventTypeAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeAxis" xlink:to="us-gaap_SubsequentEventTypeDomain" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeDomain" xlink:to="us-gaap_SubsequentEventMember" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_StatementScenarioAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementScenarioAxis" xlink:to="us-gaap_ScenarioUnspecifiedDomain" order="10420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScenarioUnspecifiedDomain" xlink:to="us-gaap_ScenarioForecastMember" order="10440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="srt_CounterpartyNameAxis" order="10030.10" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_CounterpartyNameAxis" xlink:to="srt_RepurchaseAgreementCounterpartyNameDomain" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_MitsubishiTanabePharmaCorporationMember" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_ContractWithCustomerBasisOfPricingAxis" order="10030.12" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingAxis" xlink:to="us-gaap_ContractWithCustomerBasisOfPricingDomain" order="10640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_CommercialMilestonePaymentsMember" order="10660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeCollaborationAgreementMember" order="10720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="srt_RangeAxis" order="10030.14" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10860.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_PotentialDevelopmentAndCommercializationMilestonesMember" order="11000.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_PotentialCommercialMilestonePaymentsMember" order="11020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" order="10030.16" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" xlink:to="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" order="11160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" xlink:to="akba_GlobalDevelopmentPlanMember" order="11180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_OtsukaPharmaceuticalCompanyLimitedMember" order="11260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeCollaborationAndLicenseAgreementMember" order="11400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_SubsidiarySaleOfStockAxis" order="10030.18" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsidiarySaleOfStockAxis" xlink:to="us-gaap_SaleOfStockNameOfTransactionDomain" order="12060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SaleOfStockNameOfTransactionDomain" xlink:to="akba_FollowOnPublicOfferingMember" order="12080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.20" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="12140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="12160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="us-gaap_RelatedPartyTransactionAxis" order="10030.22" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RelatedPartyTransactionAxis" xlink:to="us-gaap_RelatedPartyTransactionDomain" order="12200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RelatedPartyTransactionDomain" xlink:to="akba_CantorFitzgeraldAndCompanyMember" order="12220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_ViforPharmaMember" order="12280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_OtsukaPharmaceuticalCompanyLimitedAndMitsubishiTanabePharmaCorporationMember" order="12320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_LicenseAgreementMember" order="12400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsTable" xlink:to="akba_NatureOfOrganizationAndOperationsLineItems" order="12420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="us-gaap_StockholdersEquityNoteStockSplitConversionRatio1" order="12430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_BusinessCombinationEquityCancelledAndConvertedNumberOfSharesIssued" order="12450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_NumberOfPatients" order="12540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_NumberOfEnrolledSubjects" order="12580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="us-gaap_CollaborativeArrangementRightsAndObligations" order="12690.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_MilestonePaymentReceived" order="12710.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_UpfrontCashPaymentReceived" order="12730.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_PotentialPaymentForAchievementOfSpecifiedCommercialMilestones" order="12750.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_PotentialPaymentForAchievementOfSpecifiedDevelopmentAndRegulatoryMilestones" order="12770.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_RoyaltyPaymentPercentage" order="12790.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_PaymentReceivedForLicenseAgreementReimbursementOfPreviouslyCostsIncurred" order="12880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_CollaborativeArrangementsCostSharingPayments" order="12900.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="us-gaap_ProceedsFromIssuanceOfCommonStock" order="13100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodValueNewIssues" order="13120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesNewIssues" order="13160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_MinimumCommittedAmountInCostShareFundingAndLicensePaymentsUnderCollaborationAgreements" order="13200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="us-gaap_ProceedsFromLicenseFeesReceived" order="13220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_NatureOfOrganizationAndOperationsLineItems" xlink:to="akba_OperatingPlanSufficientlyFundedByCashResourcesPeriod" order="13270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedDividendRate" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedDividendRate" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilityForUncertainTaxPositionsCurrent" xlink:type="locator" xlink:label="us-gaap_LiabilityForUncertainTaxPositionsCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdvertisingExpense" xlink:type="locator" xlink:label="us-gaap_AdvertisingExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AssetImpairmentCharges" xlink:type="locator" xlink:label="us-gaap_AssetImpairmentCharges" />
    <loc xlink:href="akba-20181231.xsd#akba_FairValueRemeasurementsToPropertyAndEquipment" xlink:type="locator" xlink:label="akba_FairValueRemeasurementsToPropertyAndEquipment" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife" />
    <loc xlink:href="akba-20181231.xsd#akba_PaymentForLicenseAgreementReimbursementOfCostsIncurred" xlink:type="locator" xlink:label="akba_PaymentForLicenseAgreementReimbursementOfCostsIncurred" />
    <loc xlink:href="akba-20181231.xsd#akba_CostShareCostsIncurredByPartnerForLicenseAgreement" xlink:type="locator" xlink:label="akba_CostShareCostsIncurredByPartnerForLicenseAgreement" />
    <loc xlink:href="akba-20181231.xsd#akba_PaymentReceivedForLicenseAgreementReimbursementOfCostsIncurred" xlink:type="locator" xlink:label="akba_PaymentReceivedForLicenseAgreementReimbursementOfCostsIncurred" />
    <loc xlink:href="akba-20181231.xsd#akba_CostShareCostsIncurredForLicenseAgreement" xlink:type="locator" xlink:label="akba_CostShareCostsIncurredForLicenseAgreement" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Depreciation" xlink:type="locator" xlink:label="us-gaap_Depreciation" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskPercentage1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AllowanceForDoubtfulAccountsReceivable" xlink:type="locator" xlink:label="us-gaap_AllowanceForDoubtfulAccountsReceivable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NumberOfOperatingSegments" xlink:type="locator" xlink:label="us-gaap_NumberOfOperatingSegments" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NewAccountingPronouncementOrChangeInAccountingPrincipleEffectOfAdoptionQuantification" xlink:type="locator" xlink:label="us-gaap_NewAccountingPronouncementOrChangeInAccountingPrincipleEffectOfAdoptionQuantification" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiabilityRevenueRecognized" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiabilityRevenueRecognized" />
    <loc xlink:href="akba-20181231.xsd#akba_AllocatedArrangementConsiderationUnderLicenseAgreement" xlink:type="locator" xlink:label="akba_AllocatedArrangementConsiderationUnderLicenseAgreement" />
    <loc xlink:href="akba-20181231.xsd#akba_MilestonePaymentReceived" xlink:type="locator" xlink:label="akba_MilestonePaymentReceived" />
    <loc xlink:href="akba-20181231.xsd#akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:type="locator" xlink:label="akba_SummaryOfSignificantAccountingPoliciesLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SellingGeneralAndAdministrativeExpensesMember" xlink:type="locator" xlink:label="us-gaap_SellingGeneralAndAdministrativeExpensesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeStatementLocationDomain" xlink:type="locator" xlink:label="us-gaap_IncomeStatementLocationDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeStatementLocationAxis" xlink:type="locator" xlink:label="us-gaap_IncomeStatementLocationAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueInputsLevel3Member" xlink:type="locator" xlink:label="us-gaap_FairValueInputsLevel3Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:type="locator" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:type="locator" xlink:label="us-gaap_FairValueByFairValueHierarchyLevelAxis" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember_li0l2" />
    <loc xlink:href="akba-20181231.xsd#akba_OtsukaUSAgreementMember" xlink:type="locator" xlink:label="akba_OtsukaUSAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CustomerConcentrationRiskMember" xlink:type="locator" xlink:label="us-gaap_CustomerConcentrationRiskMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskByTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:type="locator" xlink:label="us-gaap_AccountsReceivableMember" />
    <loc xlink:href="akba-20181231.xsd#akba_SalesAndCollaborationRevenueGrossMember" xlink:type="locator" xlink:label="akba_SalesAndCollaborationRevenueGrossMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingStandardsUpdate201618Member" xlink:type="locator" xlink:label="us-gaap_AccountingStandardsUpdate201618Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingStandardsUpdate201409Member" xlink:type="locator" xlink:label="us-gaap_AccountingStandardsUpdate201409Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfAdoptionMember" xlink:type="locator" xlink:label="us-gaap_TypeOfAdoptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:type="locator" xlink:label="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentMilestonesPaymentMember" xlink:type="locator" xlink:label="akba_DevelopmentMilestonesPaymentMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerBasisOfPricingDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerBasisOfPricingAxis" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerBasisOfPricingAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeCollaborationAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeCollaborationAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:type="locator" xlink:label="us-gaap_ArrangementsAndNonarrangementTransactionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfArrangementAxis" xlink:type="locator" xlink:label="us-gaap_TypeOfArrangementAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_MitsubishiTanabePharmaCorporationMember" xlink:type="locator" xlink:label="akba_MitsubishiTanabePharmaCorporationMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RepurchaseAgreementCounterpartyNameDomain" xlink:type="locator" xlink:label="srt_RepurchaseAgreementCounterpartyNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_CounterpartyNameAxis" xlink:type="locator" xlink:label="srt_CounterpartyNameAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_SummaryOfSignificantAccountingPoliciesTable" xlink:type="locator" xlink:label="akba_SummaryOfSignificantAccountingPoliciesTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="akba_SummaryOfSignificantAccountingPoliciesTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="srt_CounterpartyNameAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_CounterpartyNameAxis" xlink:to="srt_RepurchaseAgreementCounterpartyNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_MitsubishiTanabePharmaCorporationMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_TypeOfArrangementAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfArrangementAxis" xlink:to="us-gaap_ArrangementsAndNonarrangementTransactionsMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeCollaborationAgreementMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_ContractWithCustomerBasisOfPricingAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingAxis" xlink:to="us-gaap_ContractWithCustomerBasisOfPricingDomain" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_DevelopmentMilestonesPaymentMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:to="us-gaap_TypeOfAdoptionMember" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfAdoptionMember" xlink:to="us-gaap_AccountingStandardsUpdate201409Member" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfAdoptionMember" xlink:to="us-gaap_AccountingStandardsUpdate201618Member" order="10440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="akba_SalesAndCollaborationRevenueGrossMember" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_AccountsReceivableMember" order="10520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_ConcentrationRiskByTypeAxis" order="10030.10" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskTypeDomain" order="10560.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_CustomerConcentrationRiskMember" order="10580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="srt_RangeAxis" order="10030.12" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_OtsukaUSAgreementMember" order="10740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember_li0l2" order="10800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_FairValueByFairValueHierarchyLevelAxis" order="10030.14" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:to="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" order="10860.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:to="us-gaap_FairValueInputsLevel3Member" order="10880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_IncomeStatementLocationAxis" order="10030.16" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_IncomeStatementLocationDomain" order="10940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationDomain" xlink:to="us-gaap_SellingGeneralAndAdministrativeExpensesMember" order="10960.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="akba_SummaryOfSignificantAccountingPoliciesLineItems" order="10980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="akba_MilestonePaymentReceived" order="10990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="akba_AllocatedArrangementConsiderationUnderLicenseAgreement" order="11030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_ContractWithCustomerLiabilityRevenueRecognized" order="11070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_NewAccountingPronouncementOrChangeInAccountingPrincipleEffectOfAdoptionQuantification" order="11140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_NumberOfOperatingSegments" order="11230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_AllowanceForDoubtfulAccountsReceivable" order="11280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_ConcentrationRiskPercentage1" order="11350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentUsefulLife" order="11420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_Depreciation" order="11490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="akba_CostShareCostsIncurredForLicenseAgreement" order="11580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="akba_PaymentReceivedForLicenseAgreementReimbursementOfCostsIncurred" order="11600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="akba_CostShareCostsIncurredByPartnerForLicenseAgreement" order="11620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="akba_PaymentForLicenseAgreementReimbursementOfCostsIncurred" order="11640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetUsefulLife" order="11690.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="akba_FairValueRemeasurementsToPropertyAndEquipment" order="11830.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_AssetImpairmentCharges" order="11890.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_AdvertisingExpense" order="11980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_LiabilityForUncertainTaxPositionsCurrent" order="12070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedDividendRate" order="12140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesImpactOnConsolidatedStatementOfOperationsAndComprehensiveLossAsResultOfAdoptingASC606Details" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesImpactOnConsolidatedStatementOfOperationsAndComprehensiveLossAsResultOfAdoptingASC606Details" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesImpactOnConsolidatedStatementOfOperationsAndComprehensiveLossAsResultOfAdoptingASC606Details">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasicAndDiluted" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareBasicAndDiluted" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:type="locator" xlink:label="us-gaap_NetIncomeLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingIncomeLoss" xlink:type="locator" xlink:label="us-gaap_OperatingIncomeLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfRevenueExtensibleList" xlink:type="locator" xlink:label="us-gaap_TypeOfRevenueExtensibleList" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionLineItems" xlink:type="locator" xlink:label="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingStandardsUpdate201409Member" xlink:type="locator" xlink:label="us-gaap_AccountingStandardsUpdate201409Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfAdoptionMember" xlink:type="locator" xlink:label="us-gaap_TypeOfAdoptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:type="locator" xlink:label="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DifferenceBetweenRevenueGuidanceInEffectBeforeAndAfterTopic606Member" xlink:type="locator" xlink:label="us-gaap_DifferenceBetweenRevenueGuidanceInEffectBeforeAndAfterTopic606Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CalculatedUnderRevenueGuidanceInEffectBeforeTopic606Member" xlink:type="locator" xlink:label="us-gaap_CalculatedUnderRevenueGuidanceInEffectBeforeTopic606Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" xlink:type="locator" xlink:label="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" xlink:type="locator" xlink:label="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionTable" xlink:type="locator" xlink:label="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionTable" xlink:to="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" xlink:to="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" xlink:to="us-gaap_CalculatedUnderRevenueGuidanceInEffectBeforeTopic606Member" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" xlink:to="us-gaap_DifferenceBetweenRevenueGuidanceInEffectBeforeAndAfterTopic606Member" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionTable" xlink:to="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:to="us-gaap_TypeOfAdoptionMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfAdoptionMember" xlink:to="us-gaap_AccountingStandardsUpdate201409Member" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionTable" xlink:to="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionLineItems" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionLineItems" xlink:to="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/positiveLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionLineItems" xlink:to="us-gaap_TypeOfRevenueExtensibleList" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionLineItems" xlink:to="us-gaap_OperatingIncomeLoss" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionLineItems" xlink:to="us-gaap_NetIncomeLoss" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueInitialApplicationPeriodCumulativeEffectTransitionLineItems" xlink:to="us-gaap_EarningsPerShareBasicAndDiluted" order="10450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesImpactOnConsolidatedBalanceSheetsAsResultOfAdoptingASC606Details" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesImpactOnConsolidatedBalanceSheetsAsResultOfAdoptingASC606Details" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesImpactOnConsolidatedBalanceSheetsAsResultOfAdoptingASC606Details">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RetainedEarningsAccumulatedDeficit" xlink:type="locator" xlink:label="us-gaap_RetainedEarningsAccumulatedDeficit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiabilityCurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiabilityCurrent" />
    <loc xlink:href="akba-20181231.xsd#akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:type="locator" xlink:label="akba_SummaryOfSignificantAccountingPoliciesLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingStandardsUpdate201409Member" xlink:type="locator" xlink:label="us-gaap_AccountingStandardsUpdate201409Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfAdoptionMember" xlink:type="locator" xlink:label="us-gaap_TypeOfAdoptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:type="locator" xlink:label="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DifferenceBetweenRevenueGuidanceInEffectBeforeAndAfterTopic606Member" xlink:type="locator" xlink:label="us-gaap_DifferenceBetweenRevenueGuidanceInEffectBeforeAndAfterTopic606Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CalculatedUnderRevenueGuidanceInEffectBeforeTopic606Member" xlink:type="locator" xlink:label="us-gaap_CalculatedUnderRevenueGuidanceInEffectBeforeTopic606Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" xlink:type="locator" xlink:label="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" xlink:type="locator" xlink:label="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_SummaryOfSignificantAccountingPoliciesTable" xlink:type="locator" xlink:label="akba_SummaryOfSignificantAccountingPoliciesTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="akba_SummaryOfSignificantAccountingPoliciesTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" xlink:to="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" xlink:to="us-gaap_CalculatedUnderRevenueGuidanceInEffectBeforeTopic606Member" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" xlink:to="us-gaap_DifferenceBetweenRevenueGuidanceInEffectBeforeAndAfterTopic606Member" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:to="us-gaap_TypeOfAdoptionMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfAdoptionMember" xlink:to="us-gaap_AccountingStandardsUpdate201409Member" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="akba_SummaryOfSignificantAccountingPoliciesLineItems" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_ContractWithCustomerLiabilityCurrent" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_RetainedEarningsAccumulatedDeficit" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesImpactOnConsolidatedStatementOfCashFlowsAsResultOfAdoptingASC606Details" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesImpactOnConsolidatedStatementOfCashFlowsAsResultOfAdoptingASC606Details" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesImpactOnConsolidatedStatementOfCashFlowsAsResultOfAdoptingASC606Details">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInContractWithCustomerLiability" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInContractWithCustomerLiability" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:type="locator" xlink:label="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:type="locator" xlink:label="us-gaap_NetIncomeLoss" />
    <loc xlink:href="akba-20181231.xsd#akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:type="locator" xlink:label="akba_SummaryOfSignificantAccountingPoliciesLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingStandardsUpdate201409Member" xlink:type="locator" xlink:label="us-gaap_AccountingStandardsUpdate201409Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfAdoptionMember" xlink:type="locator" xlink:label="us-gaap_TypeOfAdoptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:type="locator" xlink:label="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DifferenceBetweenRevenueGuidanceInEffectBeforeAndAfterTopic606Member" xlink:type="locator" xlink:label="us-gaap_DifferenceBetweenRevenueGuidanceInEffectBeforeAndAfterTopic606Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CalculatedUnderRevenueGuidanceInEffectBeforeTopic606Member" xlink:type="locator" xlink:label="us-gaap_CalculatedUnderRevenueGuidanceInEffectBeforeTopic606Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" xlink:type="locator" xlink:label="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" xlink:type="locator" xlink:label="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_SummaryOfSignificantAccountingPoliciesTable" xlink:type="locator" xlink:label="akba_SummaryOfSignificantAccountingPoliciesTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="akba_SummaryOfSignificantAccountingPoliciesTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionAxis" xlink:to="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" xlink:to="us-gaap_CalculatedUnderRevenueGuidanceInEffectBeforeTopic606Member" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InitialApplicationPeriodCumulativeEffectTransitionDomain" xlink:to="us-gaap_DifferenceBetweenRevenueGuidanceInEffectBeforeAndAfterTopic606Member" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsForNewAccountingPronouncementsAxis" xlink:to="us-gaap_TypeOfAdoptionMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfAdoptionMember" xlink:to="us-gaap_AccountingStandardsUpdate201409Member" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="akba_SummaryOfSignificantAccountingPoliciesLineItems" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_NetIncomeLoss" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AdjustmentsToReconcileNetIncomeLossToCashProvidedByUsedInOperatingActivitiesAbstract" xlink:to="us-gaap_IncreaseDecreaseInContractWithCustomerLiability" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" order="10450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents_li0l2" order="10510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesReconciliationOfCashCashEquivalentsAndRestrictedCashDetails" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesReconciliationOfCashCashEquivalentsAndRestrictedCashDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesReconciliationOfCashCashEquivalentsAndRestrictedCashDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedCashNoncurrent" xlink:type="locator" xlink:label="us-gaap_RestrictedCashNoncurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:type="locator" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue" />
    <loc xlink:href="akba-20181231.xsd#akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:type="locator" xlink:label="akba_SummaryOfSignificantAccountingPoliciesLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherNoncurrentAssetsMember" xlink:type="locator" xlink:label="us-gaap_OtherNoncurrentAssetsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationDomain" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationAxis" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_SummaryOfSignificantAccountingPoliciesTable" xlink:type="locator" xlink:label="akba_SummaryOfSignificantAccountingPoliciesTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="akba_SummaryOfSignificantAccountingPoliciesTable" order="10040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="us-gaap_BalanceSheetLocationAxis" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationAxis" xlink:to="us-gaap_BalanceSheetLocationDomain" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationDomain" xlink:to="us-gaap_OtherNoncurrentAssetsMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesTable" xlink:to="akba_SummaryOfSignificantAccountingPoliciesLineItems" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_RestrictedCashNoncurrent" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_SummaryOfSignificantAccountingPoliciesLineItems" xlink:to="us-gaap_CashCashEquivalentsRestrictedCashAndRestrictedCashEquivalents" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesRevenueAndGrossAccountsReceivableByMajorCustomerDetails" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesRevenueAndGrossAccountsReceivableByMajorCustomerDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesRevenueAndGrossAccountsReceivableByMajorCustomerDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskPercentage1" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskPercentage1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskLineItems" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:type="locator" xlink:label="us-gaap_AccountsReceivableMember" />
    <loc xlink:href="akba-20181231.xsd#akba_AmerisourceBergenDrugCorporationMember" xlink:type="locator" xlink:label="akba_AmerisourceBergenDrugCorporationMember" />
    <loc xlink:href="akba-20181231.xsd#akba_CardinalHealthIncMember" xlink:type="locator" xlink:label="akba_CardinalHealthIncMember" />
    <loc xlink:href="akba-20181231.xsd#akba_McKessonCorporationMember" xlink:type="locator" xlink:label="akba_McKessonCorporationMember" />
    <loc xlink:href="akba-20181231.xsd#akba_FreseniusMedicalCareRxMember" xlink:type="locator" xlink:label="akba_FreseniusMedicalCareRxMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CustomerConcentrationRiskMember" xlink:type="locator" xlink:label="us-gaap_CustomerConcentrationRiskMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskTypeDomain" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByTypeAxis" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskByTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_OtsukaPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_OtsukaPharmaceuticalCompanyLimitedMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RepurchaseAgreementCounterpartyNameDomain" xlink:type="locator" xlink:label="srt_RepurchaseAgreementCounterpartyNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_CounterpartyNameAxis" xlink:type="locator" xlink:label="srt_CounterpartyNameAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_SalesAndCollaborationRevenueGrossMember" xlink:type="locator" xlink:label="akba_SalesAndCollaborationRevenueGrossMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskBenchmarkDomain" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskBenchmarkDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskByBenchmarkAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ConcentrationRiskTable" xlink:type="locator" xlink:label="us-gaap_ConcentrationRiskTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ConcentrationRiskTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTable" xlink:to="us-gaap_ConcentrationRiskByBenchmarkAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByBenchmarkAxis" xlink:to="us-gaap_ConcentrationRiskBenchmarkDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="akba_SalesAndCollaborationRevenueGrossMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTable" xlink:to="srt_CounterpartyNameAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_CounterpartyNameAxis" xlink:to="srt_RepurchaseAgreementCounterpartyNameDomain" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_OtsukaPharmaceuticalCompanyLimitedMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTable" xlink:to="us-gaap_ConcentrationRiskByTypeAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskByTypeAxis" xlink:to="us-gaap_ConcentrationRiskTypeDomain" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTypeDomain" xlink:to="us-gaap_CustomerConcentrationRiskMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_FreseniusMedicalCareRxMember" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_McKessonCorporationMember" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_CardinalHealthIncMember" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_AmerisourceBergenDrugCorporationMember" order="10400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskBenchmarkDomain" xlink:to="us-gaap_AccountsReceivableMember" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskTable" xlink:to="us-gaap_ConcentrationRiskLineItems" order="10600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ConcentrationRiskLineItems" xlink:to="us-gaap_ConcentrationRiskPercentage1" order="10610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesSummaryOfPropertyAndEquipmentAndRelatedAccumulatedDepreciationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureSummaryOfSignificantAccountingPoliciesSummaryOfPropertyAndEquipmentAndRelatedAccumulatedDepreciationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureSummaryOfSignificantAccountingPoliciesSummaryOfPropertyAndEquipmentAndRelatedAccumulatedDepreciationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentNet" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" xlink:type="locator" xlink:label="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentGross" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentGross" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentEstimatedUsefulLives" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentEstimatedUsefulLives" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentUsefulLife" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentUsefulLife" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentLineItems" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OfficeEquipmentMember" xlink:type="locator" xlink:label="us-gaap_OfficeEquipmentMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LeaseholdImprovementsMember" xlink:type="locator" xlink:label="us-gaap_LeaseholdImprovementsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquipmentMember" xlink:type="locator" xlink:label="us-gaap_EquipmentMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FurnitureAndFixturesMember" xlink:type="locator" xlink:label="us-gaap_FurnitureAndFixturesMember" />
    <loc xlink:href="akba-20181231.xsd#akba_ComputerEquipmentAndSoftwareMember" xlink:type="locator" xlink:label="akba_ComputerEquipmentAndSoftwareMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountingPoliciesAbstract" xlink:type="locator" xlink:label="us-gaap_AccountingPoliciesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AccountingPoliciesAbstract" xlink:to="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="akba_ComputerEquipmentAndSoftwareMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_FurnitureAndFixturesMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_EquipmentMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_LeaseholdImprovementsMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="us-gaap_OfficeEquipmentMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:to="srt_RangeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfPropertyPlantAndEquipmentTable" xlink:to="us-gaap_PropertyPlantAndEquipmentLineItems" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentUsefulLife" order="10470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentEstimatedUsefulLives" order="10550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentGross" order="10660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_AccumulatedDepreciationDepletionAndAmortizationPropertyPlantAndEquipment" order="10900.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentLineItems" xlink:to="us-gaap_PropertyPlantAndEquipmentNet" order="10940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureProductRevenueNetAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureProductRevenueNetAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureProductRevenueNetAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisaggregationOfRevenueLineItems" xlink:type="locator" xlink:label="us-gaap_DisaggregationOfRevenueLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProductMember" xlink:type="locator" xlink:label="us-gaap_ProductMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:type="locator" xlink:label="srt_ProductsAndServicesDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:type="locator" xlink:label="srt_ProductOrServiceAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisaggregationOfRevenueTable" xlink:type="locator" xlink:label="us-gaap_DisaggregationOfRevenueTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerAbstract" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueFromContractWithCustomerAbstract" xlink:to="us-gaap_DisaggregationOfRevenueTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisaggregationOfRevenueTable" xlink:to="srt_ProductOrServiceAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_ProductMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisaggregationOfRevenueTable" xlink:to="us-gaap_DisaggregationOfRevenueLineItems" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisaggregationOfRevenueLineItems" xlink:to="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureProductRevenueNetSummaryOfProductRevenueAllowanceAndReserveCategoriesDetails" xlink:href="akba-20181231.xsd#Role_DisclosureProductRevenueNetSummaryOfProductRevenueAllowanceAndReserveCategoriesDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureProductRevenueNetSummaryOfProductRevenueAllowanceAndReserveCategoriesDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ValuationAllowancesAndReservesBalance" xlink:type="locator" xlink:label="us-gaap_ValuationAllowancesAndReservesBalance_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ValuationAllowancesAndReservesDeductions" xlink:type="locator" xlink:label="us-gaap_ValuationAllowancesAndReservesDeductions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense" xlink:type="locator" xlink:label="us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ValuationAllowancesAndReservesBalance" xlink:type="locator" xlink:label="us-gaap_ValuationAllowancesAndReservesBalance" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ValuationAndQualifyingAccountsDisclosureLineItems" xlink:type="locator" xlink:label="srt_ValuationAndQualifyingAccountsDisclosureLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_ReturnsMember" xlink:type="locator" xlink:label="akba_ReturnsMember" />
    <loc xlink:href="akba-20181231.xsd#akba_RebatesFeesAndOtherDeductionsMember" xlink:type="locator" xlink:label="akba_RebatesFeesAndOtherDeductionsMember" />
    <loc xlink:href="akba-20181231.xsd#akba_ChargebacksAndDiscountsMember" xlink:type="locator" xlink:label="akba_ChargebacksAndDiscountsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ValuationAllowancesAndReservesDomain" xlink:type="locator" xlink:label="us-gaap_ValuationAllowancesAndReservesDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ValuationAllowancesAndReservesTypeAxis" xlink:type="locator" xlink:label="us-gaap_ValuationAllowancesAndReservesTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ValuationAndQualifyingAccountsDisclosureTable" xlink:type="locator" xlink:label="srt_ValuationAndQualifyingAccountsDisclosureTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerAbstract" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RevenueFromContractWithCustomerAbstract" xlink:to="srt_ValuationAndQualifyingAccountsDisclosureTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ValuationAndQualifyingAccountsDisclosureTable" xlink:to="us-gaap_ValuationAllowancesAndReservesTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ValuationAllowancesAndReservesTypeAxis" xlink:to="us-gaap_ValuationAllowancesAndReservesDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ValuationAllowancesAndReservesDomain" xlink:to="akba_ChargebacksAndDiscountsMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ValuationAllowancesAndReservesDomain" xlink:to="akba_RebatesFeesAndOtherDeductionsMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ValuationAllowancesAndReservesDomain" xlink:to="akba_ReturnsMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ValuationAndQualifyingAccountsDisclosureTable" xlink:to="srt_ValuationAndQualifyingAccountsDisclosureLineItems" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ValuationAndQualifyingAccountsDisclosureLineItems" xlink:to="us-gaap_ValuationAllowancesAndReservesBalance" order="10150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ValuationAndQualifyingAccountsDisclosureLineItems" xlink:to="us-gaap_ValuationAllowancesAndReservesChargedToCostAndExpense" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ValuationAndQualifyingAccountsDisclosureLineItems" xlink:to="us-gaap_ValuationAllowancesAndReservesDeductions" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ValuationAndQualifyingAccountsDisclosureLineItems" xlink:to="us-gaap_ValuationAllowancesAndReservesBalance_li0l2" order="10450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureLicenseCollaborationAndOtherSignificantAgreementsAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsAdditionalInformationDetails">
    <loc xlink:href="akba-20181231.xsd#akba_PriorWrittenNoticeForTerminationOnBreachOfAgreementPeriod" xlink:type="locator" xlink:label="akba_PriorWrittenNoticeForTerminationOnBreachOfAgreementPeriod" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialPaymentForAchievementOfAnnualNetSalesMilestones" xlink:type="locator" xlink:label="akba_PotentialPaymentForAchievementOfAnnualNetSalesMilestones" />
    <loc xlink:href="akba-20181231.xsd#akba_RoyaltyPaymentsDueToRelatedParty" xlink:type="locator" xlink:label="akba_RoyaltyPaymentsDueToRelatedParty" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseAgreementPayment" xlink:type="locator" xlink:label="akba_LicenseAgreementPayment" />
    <loc xlink:href="akba-20181231.xsd#akba_CollaborativeArrangementOfPremiumAmountOverClosingStockPriceOfCommonStock" xlink:type="locator" xlink:label="akba_CollaborativeArrangementOfPremiumAmountOverClosingStockPriceOfCommonStock" />
    <loc xlink:href="akba-20181231.xsd#akba_ClosingStockPriceOfCommonStock" xlink:type="locator" xlink:label="akba_ClosingStockPriceOfCommonStock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProceedsFromIssuanceOfCommonStock" xlink:type="locator" xlink:label="us-gaap_ProceedsFromIssuanceOfCommonStock" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SaleOfStockPricePerShare" xlink:type="locator" xlink:label="us-gaap_SaleOfStockPricePerShare" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockSharesIssued" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesIssued" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfWarrantOrRightExercisePriceOfWarrantsOrRights1" xlink:type="locator" xlink:label="us-gaap_ClassOfWarrantOrRightExercisePriceOfWarrantsOrRights1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WarrantsNotSettleableInCashFairValueDisclosure" xlink:type="locator" xlink:label="us-gaap_WarrantsNotSettleableInCashFairValueDisclosure" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfWarrantOrRightNumberOfSecuritiesCalledByWarrantsOrRights" xlink:type="locator" xlink:label="us-gaap_ClassOfWarrantOrRightNumberOfSecuritiesCalledByWarrantsOrRights" />
    <loc xlink:href="akba-20181231.xsd#akba_UpfrontPaymentPaidInCash" xlink:type="locator" xlink:label="akba_UpfrontPaymentPaidInCash" />
    <loc xlink:href="akba-20181231.xsd#akba_MilestoneOrRoyaltyPaymentReceived" xlink:type="locator" xlink:label="akba_MilestoneOrRoyaltyPaymentReceived" />
    <loc xlink:href="akba-20181231.xsd#akba_EstimateSubsequentCostFundingUnderPlan" xlink:type="locator" xlink:label="akba_EstimateSubsequentCostFundingUnderPlan" />
    <loc xlink:href="akba-20181231.xsd#akba_PaymentForLicenseAgreementReimbursementOfCostsIncurred" xlink:type="locator" xlink:label="akba_PaymentForLicenseAgreementReimbursementOfCostsIncurred" />
    <loc xlink:href="akba-20181231.xsd#akba_CostShareCostsIncurredByPartnerForLicenseAgreement" xlink:type="locator" xlink:label="akba_CostShareCostsIncurredByPartnerForLicenseAgreement" />
    <loc xlink:href="akba-20181231.xsd#akba_PaymentReceivedForLicenseAgreementReimbursementOfCostsIncurred" xlink:type="locator" xlink:label="akba_PaymentReceivedForLicenseAgreementReimbursementOfCostsIncurred" />
    <loc xlink:href="akba-20181231.xsd#akba_CostShareCostsIncurredForLicenseAgreement" xlink:type="locator" xlink:label="akba_CostShareCostsIncurredForLicenseAgreement" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiabilityNoncurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiabilityNoncurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiabilityCurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiabilityCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueInformationUsedToDetermineTransactionPrice" xlink:type="locator" xlink:label="us-gaap_RevenueInformationUsedToDetermineTransactionPrice" />
    <loc xlink:href="akba-20181231.xsd#akba_PaymentReceivableForLicenseAgreementReimbursementOfPreviouslyCostsIncurred" xlink:type="locator" xlink:label="akba_PaymentReceivableForLicenseAgreementReimbursementOfPreviouslyCostsIncurred" />
    <loc xlink:href="akba-20181231.xsd#akba_CollaborativeAndLicenseArrangementTransactionPrice" xlink:type="locator" xlink:label="akba_CollaborativeAndLicenseArrangementTransactionPrice" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseAgreementTerminationNoticePeriod" xlink:type="locator" xlink:label="akba_LicenseAgreementTerminationNoticePeriod" />
    <loc xlink:href="akba-20181231.xsd#akba_ThresholdForPercentageOfMarketPenetrationForLicenseAgreementExpiration" xlink:type="locator" xlink:label="akba_ThresholdForPercentageOfMarketPenetrationForLicenseAgreementExpiration" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialPaymentForAchievementOfSpecifiedRegulatoryMilestones" xlink:type="locator" xlink:label="akba_PotentialPaymentForAchievementOfSpecifiedRegulatoryMilestones" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialPaymentForAchievementOfSpecifiedDevelopmentMilestones" xlink:type="locator" xlink:label="akba_PotentialPaymentForAchievementOfSpecifiedDevelopmentMilestones" />
    <loc xlink:href="akba-20181231.xsd#akba_PercentageOfRemainingCreditableAmountAppliedToFuturePayments" xlink:type="locator" xlink:label="akba_PercentageOfRemainingCreditableAmountAppliedToFuturePayments" />
    <loc xlink:href="akba-20181231.xsd#akba_ReductionInPercentageOfFuturePaymentsDueUponCurrentGlobalDevelopmentCostsCreditable" xlink:type="locator" xlink:label="akba_ReductionInPercentageOfFuturePaymentsDueUponCurrentGlobalDevelopmentCostsCreditable" />
    <loc xlink:href="akba-20181231.xsd#akba_PercentageOfIncreaseInFundingToFundCurrentGlobalDevelopmentCosts" xlink:type="locator" xlink:label="akba_PercentageOfIncreaseInFundingToFundCurrentGlobalDevelopmentCosts" />
    <loc xlink:href="akba-20181231.xsd#akba_CollaborativeArrangementsCostSharingPayments" xlink:type="locator" xlink:label="akba_CollaborativeArrangementsCostSharingPayments" />
    <loc xlink:href="akba-20181231.xsd#akba_PaymentReceivedForLicenseAgreementReimbursementOfPreviouslyCostsIncurred" xlink:type="locator" xlink:label="akba_PaymentReceivedForLicenseAgreementReimbursementOfPreviouslyCostsIncurred" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableGross" xlink:type="locator" xlink:label="us-gaap_AccountsReceivableGross" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiability" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiability" />
    <loc xlink:href="akba-20181231.xsd#akba_CostOfResearchServices" xlink:type="locator" xlink:label="akba_CostOfResearchServices" />
    <loc xlink:href="akba-20181231.xsd#akba_NumberOfPerformanceObligations" xlink:type="locator" xlink:label="akba_NumberOfPerformanceObligations" />
    <loc xlink:href="akba-20181231.xsd#akba_DataAccessFeeReceivable" xlink:type="locator" xlink:label="akba_DataAccessFeeReceivable" />
    <loc xlink:href="akba-20181231.xsd#akba_AdditionalMilestoneOrRoyaltyPaymentsReceived" xlink:type="locator" xlink:label="akba_AdditionalMilestoneOrRoyaltyPaymentsReceived" />
    <loc xlink:href="akba-20181231.xsd#akba_MilestonePaymentReceived" xlink:type="locator" xlink:label="akba_MilestonePaymentReceived" />
    <loc xlink:href="akba-20181231.xsd#akba_CollaborationAgreementTerminationNoticePeriod" xlink:type="locator" xlink:label="akba_CollaborationAgreementTerminationNoticePeriod" />
    <loc xlink:href="akba-20181231.xsd#akba_CollaborationAgreementExpirationPeriod" xlink:type="locator" xlink:label="akba_CollaborationAgreementExpirationPeriod" />
    <loc xlink:href="akba-20181231.xsd#akba_ProceedsFromReimbursementOfDevelopmentCostsIncurred" xlink:type="locator" xlink:label="akba_ProceedsFromReimbursementOfDevelopmentCostsIncurred" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentCostsIncurred" xlink:type="locator" xlink:label="akba_DevelopmentCostsIncurred" />
    <loc xlink:href="akba-20181231.xsd#akba_PercentageOfRoyaltyPaymentsOnSales" xlink:type="locator" xlink:label="akba_PercentageOfRoyaltyPaymentsOnSales" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialPaymentForAchievementOfSpecifiedCommercialMilestones" xlink:type="locator" xlink:label="akba_PotentialPaymentForAchievementOfSpecifiedCommercialMilestones" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialPaymentForAchievementOfSpecifiedDevelopmentAndRegulatoryMilestones" xlink:type="locator" xlink:label="akba_PotentialPaymentForAchievementOfSpecifiedDevelopmentAndRegulatoryMilestones" />
    <loc xlink:href="akba-20181231.xsd#akba_IncurredClinicalAndCommercialDevelopmentCost" xlink:type="locator" xlink:label="akba_IncurredClinicalAndCommercialDevelopmentCost" />
    <loc xlink:href="akba-20181231.xsd#akba_UpfrontCashPaymentReceived" xlink:type="locator" xlink:label="akba_UpfrontCashPaymentReceived" />
    <loc xlink:href="akba-20181231.xsd#akba_PotentialPaymentForAchievementOfSpecifiedMilestones" xlink:type="locator" xlink:label="akba_PotentialPaymentForAchievementOfSpecifiedMilestones" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:type="locator" xlink:label="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_SublicenseAgreementMember" xlink:type="locator" xlink:label="akba_SublicenseAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_JapanTobaccoIncorporationAndToriiPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_JapanTobaccoIncorporationAndToriiPharmaceuticalCompanyLimitedMember_li0l2" />
    <loc xlink:href="akba-20181231.xsd#akba_PanionAndBFBiotechIncorporationMember" xlink:type="locator" xlink:label="akba_PanionAndBFBiotechIncorporationMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RelatedPartyDomain" xlink:type="locator" xlink:label="us-gaap_RelatedPartyDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RelatedPartyTransactionsByRelatedPartyAxis" xlink:type="locator" xlink:label="us-gaap_RelatedPartyTransactionsByRelatedPartyAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseAgreementMember" xlink:type="locator" xlink:label="akba_LicenseAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_ViforInternationalLimitedMember" xlink:type="locator" xlink:label="akba_ViforInternationalLimitedMember" />
    <loc xlink:href="akba-20181231.xsd#akba_JohnsonAndJohnsonInnovationMember" xlink:type="locator" xlink:label="akba_JohnsonAndJohnsonInnovationMember" />
    <loc xlink:href="akba-20181231.xsd#akba_JanssenPharmaceuticaNVMember" xlink:type="locator" xlink:label="akba_JanssenPharmaceuticaNVMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeInternationalCollaborationAndLicenseAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeInternationalCollaborationAndLicenseAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableMember" xlink:type="locator" xlink:label="us-gaap_AccountsPayableMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationDomain" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationAxis" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationAxis" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember_li0l2" />
    <loc xlink:href="akba-20181231.xsd#akba_GlobalDevelopmentPlanMember" xlink:type="locator" xlink:label="akba_GlobalDevelopmentPlanMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeUnitedStatesCollaborationAndLicenseAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeUnitedStatesCollaborationAndLicenseAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_UpFrontNonRefundableAndNonCreditableMember" xlink:type="locator" xlink:label="akba_UpFrontNonRefundableAndNonCreditableMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentMilestonesPaymentTwoMember" xlink:type="locator" xlink:label="akba_DevelopmentMilestonesPaymentTwoMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentMilestonesPaymentOneMember" xlink:type="locator" xlink:label="akba_DevelopmentMilestonesPaymentOneMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeResearchAndLicenseAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeResearchAndLicenseAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_NewDevelopmentAndCommercializeCollaborationAgreementMember" xlink:type="locator" xlink:label="akba_NewDevelopmentAndCommercializeCollaborationAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_RegulatoryMilestonePaymentsMember" xlink:type="locator" xlink:label="akba_RegulatoryMilestonePaymentsMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentMilestonesPaymentMember" xlink:type="locator" xlink:label="akba_DevelopmentMilestonesPaymentMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentRegulatoryAndCommercialEventsMilestonesPaymentMember" xlink:type="locator" xlink:label="akba_DevelopmentRegulatoryAndCommercialEventsMilestonesPaymentMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentRegulatoryAndSalesMilestonesMember" xlink:type="locator" xlink:label="akba_DevelopmentRegulatoryAndSalesMilestonesMember" />
    <loc xlink:href="akba-20181231.xsd#akba_CommercialMilestonePaymentsMember" xlink:type="locator" xlink:label="akba_CommercialMilestonePaymentsMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndRegulatoryMilestonesMember" xlink:type="locator" xlink:label="akba_DevelopmentAndRegulatoryMilestonesMember" />
    <loc xlink:href="akba-20181231.xsd#akba_UpfrontPaymentMember" xlink:type="locator" xlink:label="akba_UpfrontPaymentMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerBasisOfPricingDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerBasisOfPricingAxis" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerBasisOfPricingAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeCollaborationAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeCollaborationAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:type="locator" xlink:label="us-gaap_ArrangementsAndNonarrangementTransactionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfArrangementAxis" xlink:type="locator" xlink:label="us-gaap_TypeOfArrangementAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_MitsubishiTanabePharmaCorporationMember" xlink:type="locator" xlink:label="akba_MitsubishiTanabePharmaCorporationMember" />
    <loc xlink:href="akba-20181231.xsd#akba_ClinicalAndRegulatoryActivitiesMember" xlink:type="locator" xlink:label="akba_ClinicalAndRegulatoryActivitiesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_JapanTobaccoIncorporationAndToriiPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_JapanTobaccoIncorporationAndToriiPharmaceuticalCompanyLimitedMember" />
    <loc xlink:href="akba-20181231.xsd#akba_OtsukaPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_OtsukaPharmaceuticalCompanyLimitedMember" />
    <loc xlink:href="akba-20181231.xsd#akba_MitsubishiTanabePharmaCorporationAndOtsukaPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_MitsubishiTanabePharmaCorporationAndOtsukaPharmaceuticalCompanyLimitedMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RepurchaseAgreementCounterpartyNameDomain" xlink:type="locator" xlink:label="srt_RepurchaseAgreementCounterpartyNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_CounterpartyNameAxis" xlink:type="locator" xlink:label="srt_CounterpartyNameAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseCollaborationAndOtherRevenueMember" xlink:type="locator" xlink:label="akba_LicenseCollaborationAndOtherRevenueMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:type="locator" xlink:label="srt_ProductsAndServicesDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:type="locator" xlink:label="srt_ProductOrServiceAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="srt_ProductOrServiceAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="akba_LicenseCollaborationAndOtherRevenueMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="srt_CounterpartyNameAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_CounterpartyNameAxis" xlink:to="srt_RepurchaseAgreementCounterpartyNameDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_MitsubishiTanabePharmaCorporationAndOtsukaPharmaceuticalCompanyLimitedMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_OtsukaPharmaceuticalCompanyLimitedMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_JapanTobaccoIncorporationAndToriiPharmaceuticalCompanyLimitedMember" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" xlink:to="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" xlink:to="akba_ClinicalAndRegulatoryActivitiesMember" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_MitsubishiTanabePharmaCorporationMember" order="10440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_TypeOfArrangementAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfArrangementAxis" xlink:to="us-gaap_ArrangementsAndNonarrangementTransactionsMember" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeCollaborationAgreementMember" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_ContractWithCustomerBasisOfPricingAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingAxis" xlink:to="us-gaap_ContractWithCustomerBasisOfPricingDomain" order="10540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_UpfrontPaymentMember" order="10560.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_DevelopmentAndRegulatoryMilestonesMember" order="10580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_CommercialMilestonePaymentsMember" order="10600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_DevelopmentRegulatoryAndSalesMilestonesMember" order="10620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="srt_RangeAxis" order="10030.10" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_DevelopmentRegulatoryAndCommercialEventsMilestonesPaymentMember" order="11180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_DevelopmentMilestonesPaymentMember" order="11200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_RegulatoryMilestonePaymentsMember" order="11220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_NewDevelopmentAndCommercializeCollaborationAgreementMember" order="11640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeResearchAndLicenseAgreementMember" order="12300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_DevelopmentMilestonesPaymentOneMember" order="12360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_DevelopmentMilestonesPaymentTwoMember" order="12380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ContractWithCustomerBasisOfPricingDomain" xlink:to="akba_UpFrontNonRefundableAndNonCreditableMember" order="12520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeUnitedStatesCollaborationAndLicenseAgreementMember" order="12580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" xlink:to="akba_GlobalDevelopmentPlanMember" order="12640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember_li0l2" order="12720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_BalanceSheetLocationAxis" order="10030.12" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationAxis" xlink:to="us-gaap_BalanceSheetLocationDomain" order="14060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationDomain" xlink:to="us-gaap_AccountsPayableMember" order="14080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeInternationalCollaborationAndLicenseAgreementMember" order="14860.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_JanssenPharmaceuticaNVMember" order="15940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_JohnsonAndJohnsonInnovationMember" order="16180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_ViforInternationalLimitedMember" order="16300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_LicenseAgreementMember" order="16360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_RelatedPartyTransactionsByRelatedPartyAxis" order="10030.14" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RelatedPartyTransactionsByRelatedPartyAxis" xlink:to="us-gaap_RelatedPartyDomain" order="16640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_RelatedPartyDomain" xlink:to="akba_PanionAndBFBiotechIncorporationMember" order="16660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_JapanTobaccoIncorporationAndToriiPharmaceuticalCompanyLimitedMember_li0l2" order="16920.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_SublicenseAgreementMember" order="17000.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" order="17300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" order="17310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PotentialPaymentForAchievementOfSpecifiedMilestones" order="17760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_UpfrontCashPaymentReceived" order="17780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_IncurredClinicalAndCommercialDevelopmentCost" order="17800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PotentialPaymentForAchievementOfSpecifiedDevelopmentAndRegulatoryMilestones" order="17820.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PotentialPaymentForAchievementOfSpecifiedCommercialMilestones" order="17840.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PercentageOfRoyaltyPaymentsOnSales" order="17860.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_DevelopmentCostsIncurred" order="17930.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_ProceedsFromReimbursementOfDevelopmentCostsIncurred" order="17970.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_CollaborationAgreementExpirationPeriod" order="18020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_CollaborationAgreementTerminationNoticePeriod" order="18040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_MilestonePaymentReceived" order="18110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_AdditionalMilestoneOrRoyaltyPaymentsReceived" order="18190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_DataAccessFeeReceivable" order="18240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_NumberOfPerformanceObligations" order="18290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_CostOfResearchServices" order="18450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ContractWithCustomerLiability" order="18590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_AccountsReceivableGross" order="18610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PaymentReceivedForLicenseAgreementReimbursementOfPreviouslyCostsIncurred" order="18680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_CollaborativeArrangementsCostSharingPayments" order="18700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PercentageOfIncreaseInFundingToFundCurrentGlobalDevelopmentCosts" order="18720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_ReductionInPercentageOfFuturePaymentsDueUponCurrentGlobalDevelopmentCostsCreditable" order="18760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PercentageOfRemainingCreditableAmountAppliedToFuturePayments" order="18780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PotentialPaymentForAchievementOfSpecifiedDevelopmentMilestones" order="18830.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PotentialPaymentForAchievementOfSpecifiedRegulatoryMilestones" order="18850.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_ThresholdForPercentageOfMarketPenetrationForLicenseAgreementExpiration" order="18940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_LicenseAgreementTerminationNoticePeriod" order="18960.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_CollaborativeAndLicenseArrangementTransactionPrice" order="19110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PaymentReceivableForLicenseAgreementReimbursementOfPreviouslyCostsIncurred" order="19150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_RevenueInformationUsedToDetermineTransactionPrice" order="19190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ContractWithCustomerLiabilityCurrent" order="19380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/positiveLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ContractWithCustomerLiabilityNoncurrent" order="19440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/positiveLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_CostShareCostsIncurredForLicenseAgreement" order="19590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PaymentReceivedForLicenseAgreementReimbursementOfCostsIncurred" order="19610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_CostShareCostsIncurredByPartnerForLicenseAgreement" order="19630.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PaymentForLicenseAgreementReimbursementOfCostsIncurred" order="19650.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_EstimateSubsequentCostFundingUnderPlan" order="19740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_MilestoneOrRoyaltyPaymentReceived" order="19850.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_UpfrontPaymentPaidInCash" order="20330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ClassOfWarrantOrRightNumberOfSecuritiesCalledByWarrantsOrRights" order="20350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_WarrantsNotSettleableInCashFairValueDisclosure" order="20530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ClassOfWarrantOrRightExercisePriceOfWarrantsOrRights1" order="20550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_CommonStockSharesIssued" order="20700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_SaleOfStockPricePerShare" order="20720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ProceedsFromIssuanceOfCommonStock" order="20740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_ClosingStockPriceOfCommonStock" order="20760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_CollaborativeArrangementOfPremiumAmountOverClosingStockPriceOfCommonStock" order="20780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_LicenseAgreementPayment" order="20870.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_RoyaltyPaymentsDueToRelatedParty" order="20920.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PotentialPaymentForAchievementOfAnnualNetSalesMilestones" order="20970.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_PriorWrittenNoticeForTerminationOnBreachOfAgreementPeriod" order="21010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsRevenuesRecognizedFromLicenseCollaborationAndOtherSignificantAgreementsDetails" xlink:href="akba-20181231.xsd#Role_DisclosureLicenseCollaborationAndOtherSignificantAgreementsRevenuesRecognizedFromLicenseCollaborationAndOtherSignificantAgreementsDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsRevenuesRecognizedFromLicenseCollaborationAndOtherSignificantAgreementsDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseCollaborationAndOtherRevenueAbstract" xlink:type="locator" xlink:label="akba_LicenseCollaborationAndOtherRevenueAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:type="locator" xlink:label="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeInternationalCollaborationAndLicenseAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeInternationalCollaborationAndLicenseAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeUnitedStatesCollaborationAndLicenseAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeUnitedStatesCollaborationAndLicenseAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:type="locator" xlink:label="us-gaap_ArrangementsAndNonarrangementTransactionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfArrangementAxis" xlink:type="locator" xlink:label="us-gaap_TypeOfArrangementAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_JapanTobaccoIncorporationAndToriiPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_JapanTobaccoIncorporationAndToriiPharmaceuticalCompanyLimitedMember" />
    <loc xlink:href="akba-20181231.xsd#akba_MitsubishiTanabePharmaCorporationAndOtsukaPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_MitsubishiTanabePharmaCorporationAndOtsukaPharmaceuticalCompanyLimitedMember" />
    <loc xlink:href="akba-20181231.xsd#akba_OtsukaPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_OtsukaPharmaceuticalCompanyLimitedMember" />
    <loc xlink:href="akba-20181231.xsd#akba_MitsubishiTanabePharmaCorporationMember" xlink:type="locator" xlink:label="akba_MitsubishiTanabePharmaCorporationMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RepurchaseAgreementCounterpartyNameDomain" xlink:type="locator" xlink:label="srt_RepurchaseAgreementCounterpartyNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_CounterpartyNameAxis" xlink:type="locator" xlink:label="srt_CounterpartyNameAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_ClinicalAndRegulatoryActivitiesMember" xlink:type="locator" xlink:label="akba_ClinicalAndRegulatoryActivitiesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseCollaborationAndOtherRevenueMember" xlink:type="locator" xlink:label="akba_LicenseCollaborationAndOtherRevenueMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:type="locator" xlink:label="srt_ProductsAndServicesDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:type="locator" xlink:label="srt_ProductOrServiceAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="srt_ProductOrServiceAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="akba_LicenseCollaborationAndOtherRevenueMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" xlink:to="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" xlink:to="akba_ClinicalAndRegulatoryActivitiesMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="srt_CounterpartyNameAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_CounterpartyNameAxis" xlink:to="srt_RepurchaseAgreementCounterpartyNameDomain" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_MitsubishiTanabePharmaCorporationMember" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_OtsukaPharmaceuticalCompanyLimitedMember" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_MitsubishiTanabePharmaCorporationAndOtsukaPharmaceuticalCompanyLimitedMember" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_JapanTobaccoIncorporationAndToriiPharmaceuticalCompanyLimitedMember" order="10400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_TypeOfArrangementAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfArrangementAxis" xlink:to="us-gaap_ArrangementsAndNonarrangementTransactionsMember" order="10440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeUnitedStatesCollaborationAndLicenseAgreementMember" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeInternationalCollaborationAndLicenseAgreementMember" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_LicenseCollaborationAndOtherRevenueAbstract" order="10510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_LicenseCollaborationAndOtherRevenueAbstract" xlink:to="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" order="10630.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/positiveTerseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsDeferredRevenuesBalanceDetails" xlink:href="akba-20181231.xsd#Role_DisclosureLicenseCollaborationAndOtherSignificantAgreementsDeferredRevenuesBalanceDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsDeferredRevenuesBalanceDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiability" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiability" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiabilityNoncurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiabilityNoncurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiabilityCurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiabilityCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredRevenueAbstract" xlink:type="locator" xlink:label="us-gaap_DeferredRevenueAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:type="locator" xlink:label="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeInternationalCollaborationAndLicenseAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeInternationalCollaborationAndLicenseAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopmentAndCommercializeUnitedStatesCollaborationAndLicenseAgreementMember" xlink:type="locator" xlink:label="akba_DevelopmentAndCommercializeUnitedStatesCollaborationAndLicenseAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:type="locator" xlink:label="us-gaap_ArrangementsAndNonarrangementTransactionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfArrangementAxis" xlink:type="locator" xlink:label="us-gaap_TypeOfArrangementAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_ViforPharmaMember" xlink:type="locator" xlink:label="akba_ViforPharmaMember" />
    <loc xlink:href="akba-20181231.xsd#akba_OtsukaPharmaceuticalCompanyLimitedMember" xlink:type="locator" xlink:label="akba_OtsukaPharmaceuticalCompanyLimitedMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RepurchaseAgreementCounterpartyNameDomain" xlink:type="locator" xlink:label="srt_RepurchaseAgreementCounterpartyNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_CounterpartyNameAxis" xlink:type="locator" xlink:label="srt_CounterpartyNameAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" order="10040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="srt_CounterpartyNameAxis" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_CounterpartyNameAxis" xlink:to="srt_RepurchaseAgreementCounterpartyNameDomain" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_OtsukaPharmaceuticalCompanyLimitedMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_ViforPharmaMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_TypeOfArrangementAxis" order="10050.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfArrangementAxis" xlink:to="us-gaap_ArrangementsAndNonarrangementTransactionsMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeUnitedStatesCollaborationAndLicenseAgreementMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_DevelopmentAndCommercializeInternationalCollaborationAndLicenseAgreementMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_DeferredRevenueAbstract" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredRevenueAbstract" xlink:to="us-gaap_ContractWithCustomerLiabilityCurrent" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredRevenueAbstract" xlink:to="us-gaap_ContractWithCustomerLiabilityNoncurrent" order="10670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredRevenueAbstract" xlink:to="us-gaap_ContractWithCustomerLiability" order="10810.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsScheduleOfChangesInContractAssetsAndLiabilitiesDetails" xlink:href="akba-20181231.xsd#Role_DisclosureLicenseCollaborationAndOtherSignificantAgreementsScheduleOfChangesInContractAssetsAndLiabilitiesDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsScheduleOfChangesInContractAssetsAndLiabilitiesDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiability" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiability_li0l2" />
    <loc xlink:href="akba-20181231.xsd#akba_ContractWithCustomerLiabilityDeductions" xlink:type="locator" xlink:label="akba_ContractWithCustomerLiabilityDeductions" />
    <loc xlink:href="akba-20181231.xsd#akba_ContractWithCustomerLiabilityAdditions" xlink:type="locator" xlink:label="akba_ContractWithCustomerLiabilityAdditions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiability" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiability" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerAssetNetCurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerAssetNetCurrent_li0l2" />
    <loc xlink:href="akba-20181231.xsd#akba_ContractWithCustomerAssetDeductions" xlink:type="locator" xlink:label="akba_ContractWithCustomerAssetDeductions" />
    <loc xlink:href="akba-20181231.xsd#akba_ContractWithCustomerAssetAdditions" xlink:type="locator" xlink:label="akba_ContractWithCustomerAssetAdditions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerAssetNetCurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerAssetNetCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:type="locator" xlink:label="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsPayableMember" xlink:type="locator" xlink:label="us-gaap_AccountsPayableMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DeferredRevenueMember" xlink:type="locator" xlink:label="akba_DeferredRevenueMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:type="locator" xlink:label="us-gaap_AccountsReceivableMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherCurrentAssetsMember" xlink:type="locator" xlink:label="us-gaap_OtherCurrentAssetsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationDomain" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationAxis" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_BalanceSheetLocationAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationAxis" xlink:to="us-gaap_BalanceSheetLocationDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationDomain" xlink:to="us-gaap_OtherCurrentAssetsMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationDomain" xlink:to="us-gaap_AccountsReceivableMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationDomain" xlink:to="akba_DeferredRevenueMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationDomain" xlink:to="us-gaap_AccountsPayableMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ContractWithCustomerAssetNetCurrent" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_ContractWithCustomerAssetAdditions" order="10550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_ContractWithCustomerAssetDeductions" order="10770.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ContractWithCustomerAssetNetCurrent_li0l2" order="10990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ContractWithCustomerLiability" order="11240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_ContractWithCustomerLiabilityAdditions" order="11460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="akba_ContractWithCustomerLiabilityDeductions" order="11680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ContractWithCustomerLiability_li0l2" order="11900.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsScheduleOfChangesInContractAssetsAndLiabilitiesParentheticalDetails" xlink:href="akba-20181231.xsd#Role_DisclosureLicenseCollaborationAndOtherSignificantAgreementsScheduleOfChangesInContractAssetsAndLiabilitiesParentheticalDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsScheduleOfChangesInContractAssetsAndLiabilitiesParentheticalDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerAssetNetCurrent" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerAssetNetCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:type="locator" xlink:label="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccountsReceivableMember" xlink:type="locator" xlink:label="us-gaap_AccountsReceivableMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationDomain" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationAxis" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProductMember" xlink:type="locator" xlink:label="us-gaap_ProductMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:type="locator" xlink:label="srt_ProductsAndServicesDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:type="locator" xlink:label="srt_ProductOrServiceAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_ClinicalAndRegulatoryActivitiesMember" xlink:type="locator" xlink:label="akba_ClinicalAndRegulatoryActivitiesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersByTypeAxis" xlink:to="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersTypeDomain" xlink:to="akba_ClinicalAndRegulatoryActivitiesMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="srt_ProductOrServiceAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_ProductMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_BalanceSheetLocationAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationAxis" xlink:to="us-gaap_BalanceSheetLocationDomain" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationDomain" xlink:to="us-gaap_AccountsReceivableMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfCollaborativeArrangementsAndNoncollaborativeArrangementTransactionsTable" xlink:to="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CollaborativeArrangementsAndNoncollaborativeArrangementTransactionsLineItems" xlink:to="us-gaap_ContractWithCustomerAssetNetCurrent" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsScheduleOfRevenueRecognizedResultingFromChangesInContractAssetAndContractLiabilityDetails" xlink:href="akba-20181231.xsd#Role_DisclosureLicenseCollaborationAndOtherSignificantAgreementsScheduleOfRevenueRecognizedResultingFromChangesInContractAssetAndContractLiabilityDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureLicenseCollaborationAndOtherSignificantAgreementsScheduleOfRevenueRecognizedResultingFromChangesInContractAssetAndContractLiabilityDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerPerformanceObligationSatisfiedInPreviousPeriod" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerPerformanceObligationSatisfiedInPreviousPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ContractWithCustomerLiabilityRevenueRecognized" xlink:type="locator" xlink:label="us-gaap_ContractWithCustomerLiabilityRevenueRecognized" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:type="locator" xlink:label="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_ContractWithCustomerLiabilityRevenueRecognized" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_OrganizationConsolidationAndPresentationOfFinancialStatementsAbstract" xlink:to="us-gaap_ContractWithCustomerPerformanceObligationSatisfiedInPreviousPeriod" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureBusinessCombinationAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationAdditionalInformationDetails">
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationTaxBenefits" xlink:type="locator" xlink:label="akba_BusinessCombinationTaxBenefits" />
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationBonusAndSeverancePayments" xlink:type="locator" xlink:label="akba_BusinessCombinationBonusAndSeverancePayments" />
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationStockBasedCompensationExpenses" xlink:type="locator" xlink:label="akba_BusinessCombinationStockBasedCompensationExpenses" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationAcquisitionRelatedCosts" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationAcquisitionRelatedCosts" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilities" xlink:type="locator" xlink:label="us-gaap_DeferredTaxLiabilities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" />
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesFairValueOfOffMarketElement" xlink:type="locator" xlink:label="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesFairValueOfOffMarketElement" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife" />
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationRiskAdjustedDiscountRatesUsedToCalculatePresentValueOfFutureExpectedCashInflowsOfIntangibleAssets" xlink:type="locator" xlink:label="akba_BusinessCombinationRiskAdjustedDiscountRatesUsedToCalculatePresentValueOfFutureExpectedCashInflowsOfIntangibleAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredGoodwillAndLiabilitiesAssumedNet" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredGoodwillAndLiabilitiesAssumedNet" />
    <loc xlink:href="akba-20181231.xsd#akba_FairValueOfSubsidiaryOrEquityMethodInvesteeCumulativeNumberOfAdditionalSharesIssuedForAllTransactions" xlink:type="locator" xlink:label="akba_FairValueOfSubsidiaryOrEquityMethodInvesteeCumulativeNumberOfAdditionalSharesIssuedForAllTransactions" />
    <loc xlink:href="akba-20181231.xsd#akba_AggregateNumberOfSharesAvailableForConversion" xlink:type="locator" xlink:label="akba_AggregateNumberOfSharesAvailableForConversion" />
    <loc xlink:href="akba-20181231.xsd#akba_SubsidiaryOrEquityMethodInvesteeCumulativeNumberOfAdditionalSharesExpectedToBeIssuedForAllTransactions" xlink:type="locator" xlink:label="akba_SubsidiaryOrEquityMethodInvesteeCumulativeNumberOfAdditionalSharesExpectedToBeIssuedForAllTransactions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtConversionConvertedInstrumentSharesIssued1" xlink:type="locator" xlink:label="us-gaap_DebtConversionConvertedInstrumentSharesIssued1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtConversionConvertedInstrumentAmount1" xlink:type="locator" xlink:label="us-gaap_DebtConversionConvertedInstrumentAmount1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionSharePrice" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionSharePrice" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationConsiderationTransferred1" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquityNoteStockSplitConversionRatio1" xlink:type="locator" xlink:label="us-gaap_StockholdersEquityNoteStockSplitConversionRatio1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationProFormaInformationEarningsOrLossOfAcquireeSinceAcquisitionDateActual" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationProFormaInformationEarningsOrLossOfAcquireeSinceAcquisitionDateActual" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationProFormaInformationRevenueOfAcquireeSinceAcquisitionDateActual" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationProFormaInformationRevenueOfAcquireeSinceAcquisitionDateActual" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_NonRecurringChargesMember" xlink:type="locator" xlink:label="akba_NonRecurringChargesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NonrecurringAdjustmentDomain" xlink:type="locator" xlink:label="us-gaap_NonrecurringAdjustmentDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NonrecurringAdjustmentAxis" xlink:type="locator" xlink:label="us-gaap_NonrecurringAdjustmentAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GeneralAndAdministrativeExpenseMember" xlink:type="locator" xlink:label="us-gaap_GeneralAndAdministrativeExpenseMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeStatementLocationDomain" xlink:type="locator" xlink:label="us-gaap_IncomeStatementLocationDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeStatementLocationAxis" xlink:type="locator" xlink:label="us-gaap_IncomeStatementLocationAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_AuryxiaMember" xlink:type="locator" xlink:label="akba_AuryxiaMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockMember" xlink:type="locator" xlink:label="us-gaap_CommonStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_NotesConversionAgreementMember" xlink:type="locator" xlink:label="akba_NotesConversionAgreementMember" />
    <loc xlink:href="akba-20181231.xsd#akba_MergerAgreementMember" xlink:type="locator" xlink:label="akba_MergerAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:type="locator" xlink:label="us-gaap_ArrangementsAndNonarrangementTransactionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfArrangementAxis" xlink:type="locator" xlink:label="us-gaap_TypeOfArrangementAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipDomain" xlink:type="locator" xlink:label="srt_OwnershipDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipAxis" xlink:type="locator" xlink:label="srt_OwnershipAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_OwnershipAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipAxis" xlink:to="srt_OwnershipDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_TypeOfArrangementAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfArrangementAxis" xlink:to="us-gaap_ArrangementsAndNonarrangementTransactionsMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_MergerAgreementMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_NotesConversionAgreementMember" order="10600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="10760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" order="10920.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="akba_AuryxiaMember" order="10940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_IncomeStatementLocationAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_IncomeStatementLocationDomain" order="11220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationDomain" xlink:to="us-gaap_GeneralAndAdministrativeExpenseMember" order="11240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_NonrecurringAdjustmentAxis" order="10030.10" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonrecurringAdjustmentAxis" xlink:to="us-gaap_NonrecurringAdjustmentDomain" order="11420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_NonrecurringAdjustmentDomain" xlink:to="akba_NonRecurringChargesMember" order="11440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="11540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationProFormaInformationRevenueOfAcquireeSinceAcquisitionDateActual" order="11550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationProFormaInformationEarningsOrLossOfAcquireeSinceAcquisitionDateActual" order="11570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_StockholdersEquityNoteStockSplitConversionRatio1" order="11620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationConsiderationTransferred1" order="11640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessAcquisitionSharePrice" order="11690.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_DebtConversionConvertedInstrumentAmount1" order="11740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_DebtConversionConvertedInstrumentSharesIssued1" order="11760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_SubsidiaryOrEquityMethodInvesteeCumulativeNumberOfAdditionalSharesExpectedToBeIssuedForAllTransactions" order="11780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_AggregateNumberOfSharesAvailableForConversion" order="11800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_FairValueOfSubsidiaryOrEquityMethodInvesteeCumulativeNumberOfAdditionalSharesIssuedForAllTransactions" order="11840.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredGoodwillAndLiabilitiesAssumedNet" order="11890.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_BusinessCombinationRiskAdjustedDiscountRatesUsedToCalculatePresentValueOfFutureExpectedCashInflowsOfIntangibleAssets" order="11940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetUsefulLife" order="11960.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesFairValueOfOffMarketElement" order="12010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessAcquisitionPurchasePriceAllocationGoodwillExpectedTaxDeductibleAmount" order="12060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_DeferredTaxLiabilities" order="12110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationAcquisitionRelatedCosts" order="12160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_BusinessCombinationStockBasedCompensationExpenses" order="12250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_BusinessCombinationBonusAndSeverancePayments" order="12270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_BusinessCombinationTaxBenefits" order="12290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationSummaryOfTotalFairValueConsiderationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureBusinessCombinationSummaryOfTotalFairValueConsiderationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationSummaryOfTotalFairValueConsiderationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationConsiderationTransferred1" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationConsiderationTransferred1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_PrecombinationEmployeeServicesMember" xlink:type="locator" xlink:label="akba_PrecombinationEmployeeServicesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScenarioUnspecifiedDomain" xlink:type="locator" xlink:label="us-gaap_ScenarioUnspecifiedDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementScenarioAxis" xlink:type="locator" xlink:label="us-gaap_StatementScenarioAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockMember" xlink:type="locator" xlink:label="us-gaap_CommonStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockOptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockUnitsRSUMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipDomain" xlink:type="locator" xlink:label="srt_OwnershipDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipAxis" xlink:type="locator" xlink:label="srt_OwnershipAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_OwnershipAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipAxis" xlink:to="srt_OwnershipDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockUnitsRSUMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_StatementScenarioAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementScenarioAxis" xlink:to="us-gaap_ScenarioUnspecifiedDomain" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScenarioUnspecifiedDomain" xlink:to="akba_PrecombinationEmployeeServicesMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationConsiderationTransferred1" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationSummaryOfTotalFairValueConsiderationParentheticalDetails" xlink:href="akba-20181231.xsd#Role_DisclosureBusinessCombinationSummaryOfTotalFairValueConsiderationParentheticalDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationSummaryOfTotalFairValueConsiderationParentheticalDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesAcquisitions" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesAcquisitions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockOptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockUnitsRSUMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockMember" xlink:type="locator" xlink:label="us-gaap_CommonStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipDomain" xlink:type="locator" xlink:label="srt_OwnershipDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipAxis" xlink:type="locator" xlink:label="srt_OwnershipAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_OwnershipAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipAxis" xlink:to="srt_OwnershipDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockUnitsRSUMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesAcquisitions" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationSummaryOfPurchasePriceOfIdentifiableAssetsAcquiredAndLiabilitiesAssumedDetails" xlink:href="akba-20181231.xsd#Role_DisclosureBusinessCombinationSummaryOfPurchasePriceOfIdentifiableAssetsAcquiredAndLiabilitiesAssumedDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationSummaryOfPurchasePriceOfIdentifiableAssetsAcquiredAndLiabilitiesAssumedDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredGoodwillAndLiabilitiesAssumedNet" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredGoodwillAndLiabilitiesAssumedNet" />
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesFairValueOfOffMarketElement" xlink:type="locator" xlink:label="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesFairValueOfOffMarketElement" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesLongTermDebt" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesLongTermDebt" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedDeferredTaxLiabilitiesCurrent" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedDeferredTaxLiabilitiesCurrent" />
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilitiesAccruedExpenses" xlink:type="locator" xlink:label="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilitiesAccruedExpenses" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilitiesAccountsPayable" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilitiesAccountsPayable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedOtherNoncurrentAssets" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedOtherNoncurrentAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedPropertyPlantAndEquipment" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedPropertyPlantAndEquipment" />
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedOtherIntangibleAssets" xlink:type="locator" xlink:label="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedOtherIntangibleAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibleAssetsOtherThanGoodwillAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibleAssetsOtherThanGoodwillAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Goodwill" xlink:type="locator" xlink:label="us-gaap_Goodwill" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsPrepaidExpenseAndOtherAssets" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsPrepaidExpenseAndOtherAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsReceivables" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsReceivables" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedInventory" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedInventory" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCashAndEquivalents" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCashAndEquivalents" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipDomain" xlink:type="locator" xlink:label="srt_OwnershipDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipAxis" xlink:type="locator" xlink:label="srt_OwnershipAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_OwnershipAxis" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipAxis" xlink:to="srt_OwnershipDomain" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCashAndEquivalents" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedInventory" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsReceivables" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentAssetsPrepaidExpenseAndOtherAssets" order="10310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_Goodwill" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibleAssetsOtherThanGoodwillAbstract" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibleAssetsOtherThanGoodwillAbstract" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibles" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedIntangibleAssetsOtherThanGoodwillAbstract" xlink:to="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedOtherIntangibleAssets" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedPropertyPlantAndEquipment" order="10430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedOtherNoncurrentAssets" order="10450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilitiesAccountsPayable" order="10470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedCurrentLiabilitiesAccruedExpenses" order="10490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedDeferredTaxLiabilitiesCurrent" order="10510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesLongTermDebt" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesFairValueOfOffMarketElement" order="10550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessCombinationRecognizedIdentifiableAssetsAcquiredGoodwillAndLiabilitiesAssumedNet" order="10570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationSummaryOfUnauditedEstimatedProFormaFinancialInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureBusinessCombinationSummaryOfUnauditedEstimatedProFormaFinancialInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureBusinessCombinationSummaryOfUnauditedEstimatedProFormaFinancialInformationDetails">
    <loc xlink:href="akba-20181231.xsd#akba_BusinessAcquisitionProFormaEarningsPerShareBasicAndDiluted" xlink:type="locator" xlink:label="akba_BusinessAcquisitionProFormaEarningsPerShareBasicAndDiluted" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionsProFormaNetIncomeLoss" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionsProFormaNetIncomeLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionsProFormaRevenue" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionsProFormaRevenue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionLineItems" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipDomain" xlink:type="locator" xlink:label="srt_OwnershipDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipAxis" xlink:type="locator" xlink:label="srt_OwnershipAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessCombinationsAbstract" xlink:type="locator" xlink:label="us-gaap_BusinessCombinationsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessCombinationsAbstract" xlink:to="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="srt_OwnershipAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipAxis" xlink:to="srt_OwnershipDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfBusinessAcquisitionsByAcquisitionTable" xlink:to="us-gaap_BusinessAcquisitionLineItems" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessAcquisitionsProFormaRevenue" order="10150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="us-gaap_BusinessAcquisitionsProFormaNetIncomeLoss" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionLineItems" xlink:to="akba_BusinessAcquisitionProFormaEarningsPerShareBasicAndDiluted" order="10230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesSummaryOfAvailableForSaleSecuritiesAtFairValueDetails" xlink:href="akba-20181231.xsd#Role_DisclosureAvailableForSaleSecuritiesSummaryOfAvailableForSaleSecuritiesAtFairValueDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesSummaryOfAvailableForSaleSecuritiesAtFairValueDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashCashEquivalentsAndShortTermInvestments" xlink:type="locator" xlink:label="us-gaap_CashCashEquivalentsAndShortTermInvestments" />
    <loc xlink:href="akba-20181231.xsd#akba_CashCashEquivalentsAndShortTermInvestmentsAmortizedCost" xlink:type="locator" xlink:label="akba_CashCashEquivalentsAndShortTermInvestmentsAmortizedCost" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsFairValueDisclosure" xlink:type="locator" xlink:label="us-gaap_CashAndCashEquivalentsFairValueDisclosure" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsAtCarryingValue" xlink:type="locator" xlink:label="us-gaap_CashAndCashEquivalentsAtCarryingValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AvailableForSaleSecuritiesDebtSecurities" xlink:type="locator" xlink:label="us-gaap_AvailableForSaleSecuritiesDebtSecurities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedLossBeforeTax" xlink:type="locator" xlink:label="us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedLossBeforeTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedGainBeforeTax" xlink:type="locator" xlink:label="us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedGainBeforeTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AvailableForSaleDebtSecuritiesAmortizedCostBasis" xlink:type="locator" xlink:label="us-gaap_AvailableForSaleDebtSecuritiesAmortizedCostBasis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:type="locator" xlink:label="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_USGovernmentDebtSecuritiesMember" xlink:type="locator" xlink:label="us-gaap_USGovernmentDebtSecuritiesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SecurityOwnedAndSoldNotYetPurchasedFairValueSecurityNameDomain" xlink:type="locator" xlink:label="us-gaap_SecurityOwnedAndSoldNotYetPurchasedFairValueSecurityNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SecurityOwnedAndSoldNotYetPurchasedAtFairValueAxis" xlink:type="locator" xlink:label="us-gaap_SecurityOwnedAndSoldNotYetPurchasedAtFairValueAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CorporateDebtSecuritiesMember" xlink:type="locator" xlink:label="us-gaap_CorporateDebtSecuritiesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CertificatesOfDepositMember" xlink:type="locator" xlink:label="us-gaap_CertificatesOfDepositMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeCategorizationMember" xlink:type="locator" xlink:label="us-gaap_InvestmentTypeCategorizationMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeAxis" xlink:type="locator" xlink:label="us-gaap_InvestmentTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:type="locator" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" xlink:to="us-gaap_InvestmentTypeAxis" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeAxis" xlink:to="us-gaap_InvestmentTypeCategorizationMember" order="10090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_CertificatesOfDepositMember" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_CorporateDebtSecuritiesMember" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" xlink:to="us-gaap_SecurityOwnedAndSoldNotYetPurchasedAtFairValueAxis" order="10060.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SecurityOwnedAndSoldNotYetPurchasedAtFairValueAxis" xlink:to="us-gaap_SecurityOwnedAndSoldNotYetPurchasedFairValueSecurityNameDomain" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SecurityOwnedAndSoldNotYetPurchasedFairValueSecurityNameDomain" xlink:to="us-gaap_USGovernmentDebtSecuritiesMember" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" xlink:to="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_AvailableForSaleDebtSecuritiesAmortizedCostBasis" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedGainBeforeTax" order="10600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_AvailableForSaleDebtSecuritiesAccumulatedGrossUnrealizedLossBeforeTax" order="10840.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_AvailableForSaleSecuritiesDebtSecurities" order="11080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_CashAndCashEquivalentsAtCarryingValue" order="11350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_CashAndCashEquivalentsFairValueDisclosure" order="12070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="akba_CashCashEquivalentsAndShortTermInvestmentsAmortizedCost" order="12340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_CashCashEquivalentsAndShortTermInvestments" order="13060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesEstimatedFairValueOfAvailableForSaleSecuritiesByContractualMaturityDetails" xlink:href="akba-20181231.xsd#Role_DisclosureAvailableForSaleSecuritiesEstimatedFairValueOfAvailableForSaleSecuritiesByContractualMaturityDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesEstimatedFairValueOfAvailableForSaleSecuritiesByContractualMaturityDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AvailableForSaleSecuritiesDebtSecurities" xlink:type="locator" xlink:label="us-gaap_AvailableForSaleSecuritiesDebtSecurities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AvailableForSaleSecuritiesDebtSecuritiesNoncurrent" xlink:type="locator" xlink:label="us-gaap_AvailableForSaleSecuritiesDebtSecuritiesNoncurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AvailableForSaleSecuritiesDebtSecuritiesCurrent" xlink:type="locator" xlink:label="us-gaap_AvailableForSaleSecuritiesDebtSecuritiesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:type="locator" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_AvailableForSaleSecuritiesDebtSecuritiesCurrent" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_AvailableForSaleSecuritiesDebtSecuritiesNoncurrent" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_AvailableForSaleSecuritiesDebtSecurities" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureAvailableForSaleSecuritiesAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionNumberOfPositions" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionNumberOfPositions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleRealizedGainLoss" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleRealizedGainLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:type="locator" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleRealizedGainLoss" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionNumberOfPositions" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesSummaryOfAvailableForSaleSecuritiesThatWereInContinuousUnrealizedLossPositionDetails" xlink:href="akba-20181231.xsd#Role_DisclosureAvailableForSaleSecuritiesSummaryOfAvailableForSaleSecuritiesThatWereInContinuousUnrealizedLossPositionDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureAvailableForSaleSecuritiesSummaryOfAvailableForSaleSecuritiesThatWereInContinuousUnrealizedLossPositionDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPosition" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPosition" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionAccumulatedLoss" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionAccumulatedLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLonger" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLonger" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLongerAccumulatedLoss" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLongerAccumulatedLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12Months" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12Months" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12MonthsAccumulatedLoss" xlink:type="locator" xlink:label="us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12MonthsAccumulatedLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:type="locator" xlink:label="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_USGovernmentDebtSecuritiesMember" xlink:type="locator" xlink:label="us-gaap_USGovernmentDebtSecuritiesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SecurityOwnedAndSoldNotYetPurchasedFairValueSecurityNameDomain" xlink:type="locator" xlink:label="us-gaap_SecurityOwnedAndSoldNotYetPurchasedFairValueSecurityNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SecurityOwnedAndSoldNotYetPurchasedAtFairValueAxis" xlink:type="locator" xlink:label="us-gaap_SecurityOwnedAndSoldNotYetPurchasedAtFairValueAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CorporateDebtSecuritiesMember" xlink:type="locator" xlink:label="us-gaap_CorporateDebtSecuritiesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeCategorizationMember" xlink:type="locator" xlink:label="us-gaap_InvestmentTypeCategorizationMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentTypeAxis" xlink:type="locator" xlink:label="us-gaap_InvestmentTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:type="locator" xlink:label="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentsDebtAndEquitySecuritiesAbstract" xlink:to="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" xlink:to="us-gaap_InvestmentTypeAxis" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeAxis" xlink:to="us-gaap_InvestmentTypeCategorizationMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InvestmentTypeCategorizationMember" xlink:to="us-gaap_CorporateDebtSecuritiesMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" xlink:to="us-gaap_SecurityOwnedAndSoldNotYetPurchasedAtFairValueAxis" order="10070.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SecurityOwnedAndSoldNotYetPurchasedAtFairValueAxis" xlink:to="us-gaap_SecurityOwnedAndSoldNotYetPurchasedFairValueSecurityNameDomain" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SecurityOwnedAndSoldNotYetPurchasedFairValueSecurityNameDomain" xlink:to="us-gaap_USGovernmentDebtSecuritiesMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesTable" xlink:to="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12MonthsAccumulatedLoss" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPositionLessThan12Months" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLongerAccumulatedLoss" order="10730.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleContinuousUnrealizedLossPosition12MonthsOrLonger" order="10930.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPositionAccumulatedLoss" order="11130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedTotalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAvailableForSaleSecuritiesLineItems" xlink:to="us-gaap_DebtSecuritiesAvailableForSaleUnrealizedLossPosition" order="11330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsAssetsMeasuredOrDisclosedAtFairValueOnRecurringBasisDetails" xlink:href="akba-20181231.xsd#Role_DisclosureFairValueOfFinancialInstrumentsAssetsMeasuredOrDisclosedAtFairValueOnRecurringBasisDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsAssetsMeasuredOrDisclosedAtFairValueOnRecurringBasisDetails">
    <loc xlink:href="akba-20181231.xsd#akba_AvailableForSaleSecuritiesDebtSecuritiesCurrentIncludingCashAndCashEquivalents" xlink:type="locator" xlink:label="akba_AvailableForSaleSecuritiesDebtSecuritiesCurrentIncludingCashAndCashEquivalents" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AvailableForSaleSecuritiesDebtSecuritiesCurrent" xlink:type="locator" xlink:label="us-gaap_AvailableForSaleSecuritiesDebtSecuritiesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CashAndCashEquivalentsFairValueDisclosure" xlink:type="locator" xlink:label="us-gaap_CashAndCashEquivalentsFairValueDisclosure" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" xlink:type="locator" xlink:label="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CorporateDebtSecuritiesMember" xlink:type="locator" xlink:label="us-gaap_CorporateDebtSecuritiesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_USGovernmentAgenciesDebtSecuritiesMember" xlink:type="locator" xlink:label="us-gaap_USGovernmentAgenciesDebtSecuritiesMember" />
    <loc xlink:href="akba-20181231.xsd#akba_CertificatesOfDepositAvailableForSaleSecuritiesMember" xlink:type="locator" xlink:label="akba_CertificatesOfDepositAvailableForSaleSecuritiesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain" xlink:type="locator" xlink:label="us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FinancialInstrumentAxis" xlink:type="locator" xlink:label="us-gaap_FinancialInstrumentAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueInputsLevel3Member" xlink:type="locator" xlink:label="us-gaap_FairValueInputsLevel3Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueInputsLevel2Member" xlink:type="locator" xlink:label="us-gaap_FairValueInputsLevel2Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueInputsLevel1Member" xlink:type="locator" xlink:label="us-gaap_FairValueInputsLevel1Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:type="locator" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:type="locator" xlink:label="us-gaap_FairValueByFairValueHierarchyLevelAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueMeasurementsRecurringMember" xlink:type="locator" xlink:label="us-gaap_FairValueMeasurementsRecurringMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueMeasurementFrequencyDomain" xlink:type="locator" xlink:label="us-gaap_FairValueMeasurementFrequencyDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByMeasurementFrequencyAxis" xlink:type="locator" xlink:label="us-gaap_FairValueByMeasurementFrequencyAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" xlink:type="locator" xlink:label="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueDisclosuresAbstract" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" xlink:to="us-gaap_FairValueByMeasurementFrequencyAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueByMeasurementFrequencyAxis" xlink:to="us-gaap_FairValueMeasurementFrequencyDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueMeasurementFrequencyDomain" xlink:to="us-gaap_FairValueMeasurementsRecurringMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" xlink:to="us-gaap_FairValueByFairValueHierarchyLevelAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:to="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:to="us-gaap_FairValueInputsLevel1Member" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:to="us-gaap_FairValueInputsLevel2Member" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:to="us-gaap_FairValueInputsLevel3Member" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" xlink:to="us-gaap_FinancialInstrumentAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FinancialInstrumentAxis" xlink:to="us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain" xlink:to="akba_CertificatesOfDepositAvailableForSaleSecuritiesMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain" xlink:to="us-gaap_USGovernmentAgenciesDebtSecuritiesMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TransfersAndServicingOfFinancialInstrumentsTypesOfFinancialInstrumentsDomain" xlink:to="us-gaap_CorporateDebtSecuritiesMember" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" xlink:to="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" order="10560.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" xlink:to="us-gaap_CashAndCashEquivalentsFairValueDisclosure" order="10570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" xlink:to="us-gaap_AvailableForSaleSecuritiesDebtSecuritiesCurrent" order="10650.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" xlink:to="akba_AvailableForSaleSecuritiesDebtSecuritiesCurrentIncludingCashAndCashEquivalents" order="10890.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureFairValueOfFinancialInstrumentsAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureFairValueOfFinancialInstrumentsAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LiabilitiesFairValueDisclosure" xlink:type="locator" xlink:label="us-gaap_LiabilitiesFairValueDisclosure" />
    <loc xlink:href="akba-20181231.xsd#akba_AvailableForSaleSecuritiesDebtSecuritiesCurrentIncludingCashAndCashEquivalents" xlink:type="locator" xlink:label="akba_AvailableForSaleSecuritiesDebtSecuritiesCurrentIncludingCashAndCashEquivalents" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" xlink:type="locator" xlink:label="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueInputsLevel3Member" xlink:type="locator" xlink:label="us-gaap_FairValueInputsLevel3Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:type="locator" xlink:label="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:type="locator" xlink:label="us-gaap_FairValueByFairValueHierarchyLevelAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" xlink:type="locator" xlink:label="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FairValueDisclosuresAbstract" xlink:type="locator" xlink:label="us-gaap_FairValueDisclosuresAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueDisclosuresAbstract" xlink:to="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" xlink:to="us-gaap_FairValueByFairValueHierarchyLevelAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueByFairValueHierarchyLevelAxis" xlink:to="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueMeasurementsFairValueHierarchyDomain" xlink:to="us-gaap_FairValueInputsLevel3Member" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisTable" xlink:to="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" xlink:to="akba_AvailableForSaleSecuritiesDebtSecuritiesCurrentIncludingCashAndCashEquivalents" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FairValueAssetsAndLiabilitiesMeasuredOnRecurringAndNonrecurringBasisLineItems" xlink:to="us-gaap_LiabilitiesFairValueDisclosure" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureInventoryComponentsOfInventoryDetails" xlink:href="akba-20181231.xsd#Role_DisclosureInventoryComponentsOfInventoryDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureInventoryComponentsOfInventoryDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherInventory" xlink:type="locator" xlink:label="us-gaap_OtherInventory" />
    <loc xlink:href="akba-20181231.xsd#akba_InventoryGrossBeforeOtherInventory" xlink:type="locator" xlink:label="akba_InventoryGrossBeforeOtherInventory" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryGross" xlink:type="locator" xlink:label="us-gaap_InventoryGross" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryFinishedGoods" xlink:type="locator" xlink:label="us-gaap_InventoryFinishedGoods" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryWorkInProcess" xlink:type="locator" xlink:label="us-gaap_InventoryWorkInProcess" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryRawMaterials" xlink:type="locator" xlink:label="us-gaap_InventoryRawMaterials" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_InventoryDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InventoryDisclosureAbstract" xlink:to="us-gaap_InventoryRawMaterials" order="10040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InventoryDisclosureAbstract" xlink:to="us-gaap_InventoryWorkInProcess" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InventoryDisclosureAbstract" xlink:to="us-gaap_InventoryFinishedGoods" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InventoryDisclosureAbstract" xlink:to="us-gaap_InventoryGross" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InventoryDisclosureAbstract" xlink:to="akba_InventoryGrossBeforeOtherInventory" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InventoryDisclosureAbstract" xlink:to="us-gaap_OtherInventory" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureInventoryAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureInventoryAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureInventoryAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryWriteDown" xlink:type="locator" xlink:label="us-gaap_InventoryWriteDown" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InventoryDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_InventoryDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_InventoryDisclosureAbstract" xlink:to="us-gaap_InventoryWriteDown" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwillSummaryOfIntangibleAssetsDetails" xlink:href="akba-20181231.xsd#Role_DisclosureIntangibleAssetsAndGoodwillSummaryOfIntangibleAssetsDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwillSummaryOfIntangibleAssetsDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetUsefulLife" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetUsefulLife" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsNet" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsGross" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsGross" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherIntangibleAssetsMember" xlink:type="locator" xlink:label="us-gaap_OtherIntangibleAssetsMember" />
    <loc xlink:href="akba-20181231.xsd#akba_DevelopedProductRightsForAuryxiaMember" xlink:type="locator" xlink:label="akba_DevelopedProductRightsForAuryxiaMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" order="10040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" order="10050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsByMajorClassAxis" xlink:to="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="akba_DevelopedProductRightsForAuryxiaMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsMajorClassNameDomain" xlink:to="us-gaap_OtherIntangibleAssetsMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsLineItems" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsGross" order="10230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAccumulatedAmortization" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetsNet" order="10310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_FiniteLivedIntangibleAssetUsefulLife" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwillAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureIntangibleAssetsAndGoodwillAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwillAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_Goodwill" xlink:type="locator" xlink:label="us-gaap_Goodwill" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AmortizationOfIntangibleAssets" xlink:type="locator" xlink:label="us-gaap_AmortizationOfIntangibleAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipDomain" xlink:type="locator" xlink:label="srt_OwnershipDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipAxis" xlink:type="locator" xlink:label="srt_OwnershipAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="srt_OwnershipAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipAxis" xlink:to="srt_OwnershipDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfFiniteLivedIntangibleAssetsTable" xlink:to="us-gaap_FiniteLivedIntangibleAssetsLineItems" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_AmortizationOfIntangibleAssets" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_FiniteLivedIntangibleAssetsLineItems" xlink:to="us-gaap_Goodwill" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwillScheduleOfEstimatedFutureAmortizationExpenseForIntangibleAssetsDetails" xlink:href="akba-20181231.xsd#Role_DisclosureIntangibleAssetsAndGoodwillScheduleOfEstimatedFutureAmortizationExpenseForIntangibleAssetsDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIntangibleAssetsAndGoodwillScheduleOfEstimatedFutureAmortizationExpenseForIntangibleAssetsDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsNet" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseAfterYearFive" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseAfterYearFive" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" xlink:type="locator" xlink:label="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseNextTwelveMonths" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearTwo" order="10090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearThree" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFour" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseYearFive" order="10150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsAmortizationExpenseAfterYearFive" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_GoodwillAndIntangibleAssetsDisclosureAbstract" xlink:to="us-gaap_FiniteLivedIntangibleAssetsNet" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureAccruedExpensesComponentsOfAccruedExpensesDetails" xlink:href="akba-20181231.xsd#Role_DisclosureAccruedExpensesComponentsOfAccruedExpensesDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureAccruedExpensesComponentsOfAccruedExpensesDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedLiabilitiesCurrent" xlink:type="locator" xlink:label="us-gaap_AccruedLiabilitiesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherAccruedLiabilitiesCurrent" xlink:type="locator" xlink:label="us-gaap_OtherAccruedLiabilitiesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedIncomeTaxesCurrent" xlink:type="locator" xlink:label="us-gaap_AccruedIncomeTaxesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedVacationCurrent" xlink:type="locator" xlink:label="us-gaap_AccruedVacationCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedSalariesCurrent" xlink:type="locator" xlink:label="us-gaap_AccruedSalariesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedProfessionalFeesCurrent" xlink:type="locator" xlink:label="us-gaap_AccruedProfessionalFeesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedRoyaltiesCurrent" xlink:type="locator" xlink:label="us-gaap_AccruedRoyaltiesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PostemploymentBenefitsLiabilityCurrent" xlink:type="locator" xlink:label="us-gaap_PostemploymentBenefitsLiabilityCurrent" />
    <loc xlink:href="akba-20181231.xsd#akba_AccruedCommercialManufacturingCurrent" xlink:type="locator" xlink:label="akba_AccruedCommercialManufacturingCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AccruedBonusesCurrent" xlink:type="locator" xlink:label="us-gaap_AccruedBonusesCurrent" />
    <loc xlink:href="akba-20181231.xsd#akba_AccruedMergerCostsCurrent" xlink:type="locator" xlink:label="akba_AccruedMergerCostsCurrent" />
    <loc xlink:href="akba-20181231.xsd#akba_AccruedProductRevenueAllowancesCurrent" xlink:type="locator" xlink:label="akba_AccruedProductRevenueAllowancesCurrent" />
    <loc xlink:href="akba-20181231.xsd#akba_AccruedClinicalExpensesCurrent" xlink:type="locator" xlink:label="akba_AccruedClinicalExpensesCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PayablesAndAccrualsAbstract" xlink:type="locator" xlink:label="us-gaap_PayablesAndAccrualsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="akba_AccruedClinicalExpensesCurrent" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="akba_AccruedProductRevenueAllowancesCurrent" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="akba_AccruedMergerCostsCurrent" order="10210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccruedBonusesCurrent" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="akba_AccruedCommercialManufacturingCurrent" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_PostemploymentBenefitsLiabilityCurrent" order="10330.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccruedRoyaltiesCurrent" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccruedProfessionalFeesCurrent" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccruedSalariesCurrent" order="10450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccruedVacationCurrent" order="10490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccruedIncomeTaxesCurrent" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_OtherAccruedLiabilitiesCurrent" order="10570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PayablesAndAccrualsAbstract" xlink:to="us-gaap_AccruedLiabilitiesCurrent" order="10610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureDebtAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureDebtAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureDebtAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AmortizationOfFinancingCosts" xlink:type="locator" xlink:label="us-gaap_AmortizationOfFinancingCosts" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_InterestExpenseDebt" xlink:type="locator" xlink:label="us-gaap_InterestExpenseDebt" />
    <loc xlink:href="akba-20181231.xsd#akba_DebtDefaultLineOfCreditPercentage" xlink:type="locator" xlink:label="akba_DebtDefaultLineOfCreditPercentage" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DefaultLongtermDebtDescriptionOfViolationOrEventOfDefault" xlink:type="locator" xlink:label="us-gaap_DefaultLongtermDebtDescriptionOfViolationOrEventOfDefault" />
    <loc xlink:href="akba-20181231.xsd#akba_MinimumLiquidityRatio" xlink:type="locator" xlink:label="akba_MinimumLiquidityRatio" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityCovenantTerms" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityCovenantTerms" />
    <loc xlink:href="akba-20181231.xsd#akba_LineOfCreditTerminationFeePercentage" xlink:type="locator" xlink:label="akba_LineOfCreditTerminationFeePercentage" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityUnusedCapacityCommitmentFeePercentage" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityUnusedCapacityCommitmentFeePercentage" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityFrequencyOfCommitmentFeePayment" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityFrequencyOfCommitmentFeePayment" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityCommitmentFeePercentage" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeePercentage" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityCommitmentFeeDescription" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityCommitmentFeeDescription" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentTerm" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentTerm" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityFrequencyOfPayments" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityFrequencyOfPayments" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentInterestRateStatedPercentage" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentInterestRateStatedPercentage" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" xlink:type="locator" xlink:label="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LinesOfCreditCurrent" xlink:type="locator" xlink:label="us-gaap_LinesOfCreditCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityLineItems" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PrimeRateMember" xlink:type="locator" xlink:label="us-gaap_PrimeRateMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VariableRateDomain" xlink:type="locator" xlink:label="us-gaap_VariableRateDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VariableRateAxis" xlink:type="locator" xlink:label="us-gaap_VariableRateAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevolvingCreditFacilityMember" xlink:type="locator" xlink:label="us-gaap_RevolvingCreditFacilityMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CreditFacilityDomain" xlink:type="locator" xlink:label="us-gaap_CreditFacilityDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CreditFacilityAxis" xlink:type="locator" xlink:label="us-gaap_CreditFacilityAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_SiliconValleyBankMember" xlink:type="locator" xlink:label="akba_SiliconValleyBankMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityLenderDomain" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityLenderDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityAxis" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_LoanAndSecurityAgreementMember" xlink:type="locator" xlink:label="akba_LoanAndSecurityAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:type="locator" xlink:label="us-gaap_ArrangementsAndNonarrangementTransactionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfArrangementAxis" xlink:type="locator" xlink:label="us-gaap_TypeOfArrangementAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LineOfCreditFacilityTable" xlink:type="locator" xlink:label="us-gaap_LineOfCreditFacilityTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DebtDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_DebtDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DebtDisclosureAbstract" xlink:to="us-gaap_LineOfCreditFacilityTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_TypeOfArrangementAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfArrangementAxis" xlink:to="us-gaap_ArrangementsAndNonarrangementTransactionsMember" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_LoanAndSecurityAgreementMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_LineOfCreditFacilityAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityAxis" xlink:to="us-gaap_LineOfCreditFacilityLenderDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLenderDomain" xlink:to="akba_SiliconValleyBankMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_CreditFacilityAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="us-gaap_RevolvingCreditFacilityMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_VariableRateAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateAxis" xlink:to="us-gaap_VariableRateDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VariableRateDomain" xlink:to="us-gaap_PrimeRateMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="srt_RangeAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityTable" xlink:to="us-gaap_LineOfCreditFacilityLineItems" order="11160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_LineOfCreditFacilityMaximumBorrowingCapacity" order="11170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_LineOfCreditFacilityRemainingBorrowingCapacity" order="11190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_LinesOfCreditCurrent" order="11210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_DebtInstrumentBasisSpreadOnVariableRate1" order="11260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_DebtInstrumentInterestRateStatedPercentage" order="11280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_LineOfCreditFacilityFrequencyOfPayments" order="11300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_DebtInstrumentTerm" order="11320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_LineOfCreditFacilityCommitmentFeeDescription" order="11340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_LineOfCreditFacilityCommitmentFeePercentage" order="11360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_LineOfCreditFacilityFrequencyOfCommitmentFeePayment" order="11380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_LineOfCreditFacilityUnusedCapacityCommitmentFeePercentage" order="11400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="akba_LineOfCreditTerminationFeePercentage" order="11420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_LineOfCreditFacilityCovenantTerms" order="11470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="akba_MinimumLiquidityRatio" order="11490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_DefaultLongtermDebtDescriptionOfViolationOrEventOfDefault" order="11540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="akba_DebtDefaultLineOfCreditPercentage" order="11560.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_InterestExpenseDebt" order="11630.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LineOfCreditFacilityLineItems" xlink:to="us-gaap_AmortizationOfFinancingCosts" order="11650.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureWarrantAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureWarrantAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureWarrantAdditionalInformationDetails">
    <loc xlink:href="akba-20181231.xsd#akba_ClassOfWarrantOrRightExpirationDate" xlink:type="locator" xlink:label="akba_ClassOfWarrantOrRightExpirationDate" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WarrantsNotSettleableInCashFairValueDisclosure" xlink:type="locator" xlink:label="us-gaap_WarrantsNotSettleableInCashFairValueDisclosure" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfWarrantOrRightExercisePriceOfWarrantsOrRights1" xlink:type="locator" xlink:label="us-gaap_ClassOfWarrantOrRightExercisePriceOfWarrantsOrRights1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfWarrantOrRightNumberOfSecuritiesCalledByWarrantsOrRights" xlink:type="locator" xlink:label="us-gaap_ClassOfWarrantOrRightNumberOfSecuritiesCalledByWarrantsOrRights" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfWarrantOrRightLineItems" xlink:type="locator" xlink:label="us-gaap_ClassOfWarrantOrRightLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_JanssenAgreementMember" xlink:type="locator" xlink:label="akba_JanssenAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:type="locator" xlink:label="us-gaap_ArrangementsAndNonarrangementTransactionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfArrangementAxis" xlink:type="locator" xlink:label="us-gaap_TypeOfArrangementAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfWarrantOrRightTable" xlink:type="locator" xlink:label="us-gaap_ClassOfWarrantOrRightTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WarrantsAndRightsNoteDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_WarrantsAndRightsNoteDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_WarrantsAndRightsNoteDisclosureAbstract" xlink:to="us-gaap_ClassOfWarrantOrRightTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfWarrantOrRightTable" xlink:to="us-gaap_TypeOfArrangementAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfArrangementAxis" xlink:to="us-gaap_ArrangementsAndNonarrangementTransactionsMember" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_JanssenAgreementMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfWarrantOrRightTable" xlink:to="us-gaap_ClassOfWarrantOrRightLineItems" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfWarrantOrRightLineItems" xlink:to="us-gaap_ClassOfWarrantOrRightNumberOfSecuritiesCalledByWarrantsOrRights" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfWarrantOrRightLineItems" xlink:to="us-gaap_ClassOfWarrantOrRightExercisePriceOfWarrantsOrRights1" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfWarrantOrRightLineItems" xlink:to="us-gaap_WarrantsNotSettleableInCashFairValueDisclosure" order="10150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfWarrantOrRightLineItems" xlink:to="akba_ClassOfWarrantOrRightExpirationDate" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquityAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognized" xlink:type="locator" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognized" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNumberOfVestingInstallments" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNumberOfVestingInstallments" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingRights" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingRights" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsIssuedInMerger" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsIssuedInMerger" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodAggregateWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodAggregateWeightedAverageGrantDateFairValue" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingRightsFollowingAchievementOfPerformanceConditionPercentage" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingRightsFollowingAchievementOfPerformanceConditionPercentage" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingRightsUponAchievementOfPerformanceConditionPercentage" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingRightsUponAchievementOfPerformanceConditionPercentage" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardPotentialShareIssuablePercentage" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardPotentialShareIssuablePercentage" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" xlink:type="locator" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedStockOptions" xlink:type="locator" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedStockOptions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsVestedInPeriodFairValue1" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsVestedInPeriodFairValue1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" />
    <loc xlink:href="akba-20181231.xsd#akba_AllocatedShareBasedCompensationGrantedExpense" xlink:type="locator" xlink:label="akba_AllocatedShareBasedCompensationGrantedExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardDescription" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardDescription" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardPeriodicVestingNumberOfInstallments" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardPeriodicVestingNumberOfInstallments" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardAwardVestingRightsPercentage" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardAwardVestingRightsPercentage" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardSharesIssuedInPeriod" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardSharesIssuedInPeriod" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOfferingPeriod" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOfferingPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardPercentageOfOutstandingStockMaximum" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardPercentageOfOutstandingStockMaximum" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardMaximumNumberOfSharesOfOutstandingStock" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardMaximumNumberOfSharesOfOutstandingStock" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardAdditionalSharesAuthorizedPercentageOfCommonStockIssued" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardAdditionalSharesAuthorizedPercentageOfCommonStockIssued" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAssumedInMerger" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAssumedInMerger" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAssumedInAcquiredShares" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAssumedInAcquiredShares" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" />
    <loc xlink:href="akba-20181231.xsd#akba_AnnualIncreaseInAggregateNumberOfSharesReservedForFutureIssuanceAsPercentageSharesOutstanding" xlink:type="locator" xlink:label="akba_AnnualIncreaseInAggregateNumberOfSharesReservedForFutureIssuanceAsPercentageSharesOutstanding" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" xlink:type="locator" xlink:label="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AllocatedShareBasedCompensationExpense" xlink:type="locator" xlink:label="us-gaap_AllocatedShareBasedCompensationExpense" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsConvertedOutstandingOptions" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsConvertedOutstandingOptions" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardConvertedOutstandingAndUnexercisedOptionsToPurchase" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardConvertedOutstandingAndUnexercisedOptionsToPurchase" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesConversionOfConvertibleSecurities" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesConversionOfConvertibleSecurities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockholdersEquityNoteStockSplitConversionRatio1" xlink:type="locator" xlink:label="us-gaap_StockholdersEquityNoteStockSplitConversionRatio1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SaleOfStockPricePerShare" xlink:type="locator" xlink:label="us-gaap_SaleOfStockPricePerShare" />
    <loc xlink:href="akba-20181231.xsd#akba_ProceedsFromIssuanceOfCommonStockNetOfIssuanceCosts" xlink:type="locator" xlink:label="akba_ProceedsFromIssuanceOfCommonStockNetOfIssuanceCosts" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesNewIssues" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesNewIssues" />
    <loc xlink:href="akba-20181231.xsd#akba_CommonStockSalesAgreementAmount" xlink:type="locator" xlink:label="akba_CommonStockSalesAgreementAmount" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PreferredStockSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_PreferredStockSharesOutstanding" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PreferredStockSharesIssued" xlink:type="locator" xlink:label="us-gaap_PreferredStockSharesIssued" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PreferredStockParOrStatedValuePerShare" xlink:type="locator" xlink:label="us-gaap_PreferredStockParOrStatedValuePerShare" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PreferredStockSharesAuthorized" xlink:type="locator" xlink:label="us-gaap_PreferredStockSharesAuthorized" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesOutstanding" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockSharesIssued" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesIssued" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockParOrStatedValuePerShare" xlink:type="locator" xlink:label="us-gaap_CommonStockParOrStatedValuePerShare" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockSharesAuthorized" xlink:type="locator" xlink:label="us-gaap_CommonStockSharesAuthorized" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfStockLineItems" xlink:type="locator" xlink:label="us-gaap_ClassOfStockLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_StockOptionsAndRestrictedStockUnitsMember" xlink:type="locator" xlink:label="akba_StockOptionsAndRestrictedStockUnitsMember" />
    <loc xlink:href="akba-20181231.xsd#akba_NonEmployeesMember" xlink:type="locator" xlink:label="akba_NonEmployeesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationAwardTrancheTwoMember" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationAwardTrancheTwoMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationAwardTrancheOneMember" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationAwardTrancheOneMember" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationAwardTrancheFirstAnniversaryOfGrantDateMember" xlink:type="locator" xlink:label="akba_ShareBasedCompensationAwardTrancheFirstAnniversaryOfGrantDateMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VestingDomain" xlink:type="locator" xlink:label="us-gaap_VestingDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_VestingAxis" xlink:type="locator" xlink:label="us-gaap_VestingAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_TwoThousandAndFourteenEmployeeStockPurchasePlanMember" xlink:type="locator" xlink:label="akba_TwoThousandAndFourteenEmployeeStockPurchasePlanMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DirectorMember" xlink:type="locator" xlink:label="us-gaap_DirectorMember" />
    <loc xlink:href="akba-20181231.xsd#akba_EmployeesMember" xlink:type="locator" xlink:label="akba_EmployeesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TitleOfIndividualWithRelationshipToEntityDomain" xlink:type="locator" xlink:label="us-gaap_TitleOfIndividualWithRelationshipToEntityDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TitleOfIndividualAxis" xlink:type="locator" xlink:label="us-gaap_TitleOfIndividualAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockUnitsRSUMember_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockOptionMember_li0l2" />
    <loc xlink:href="akba-20181231.xsd#akba_TwoThousandAndFourteenPlansMember" xlink:type="locator" xlink:label="akba_TwoThousandAndFourteenPlansMember" />
    <loc xlink:href="akba-20181231.xsd#akba_InducementAwardProgramMember" xlink:type="locator" xlink:label="akba_InducementAwardProgramMember" />
    <loc xlink:href="akba-20181231.xsd#akba_ServiceBasedRestrictedStockUnitsMember" xlink:type="locator" xlink:label="akba_ServiceBasedRestrictedStockUnitsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockUnitsRSUMember" />
    <loc xlink:href="akba-20181231.xsd#akba_PerformanceBasedStockOptionsMember" xlink:type="locator" xlink:label="akba_PerformanceBasedStockOptionsMember" />
    <loc xlink:href="akba-20181231.xsd#akba_ServiceBasedStockOptionsMember" xlink:type="locator" xlink:label="akba_ServiceBasedStockOptionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockOptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_MergerAgreementMember" xlink:type="locator" xlink:label="akba_MergerAgreementMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:type="locator" xlink:label="us-gaap_ArrangementsAndNonarrangementTransactionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TypeOfArrangementAxis" xlink:type="locator" xlink:label="us-gaap_TypeOfArrangementAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipDomain" xlink:type="locator" xlink:label="srt_OwnershipDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipAxis" xlink:type="locator" xlink:label="srt_OwnershipAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_FollowOnPublicOfferingMember" xlink:type="locator" xlink:label="akba_FollowOnPublicOfferingMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SaleOfStockNameOfTransactionDomain" xlink:type="locator" xlink:label="us-gaap_SaleOfStockNameOfTransactionDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsidiarySaleOfStockAxis" xlink:type="locator" xlink:label="us-gaap_SubsidiarySaleOfStockAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockMember" xlink:type="locator" xlink:label="us-gaap_CommonStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_AtTheMarketEquityOfferingProgramMember" xlink:type="locator" xlink:label="akba_AtTheMarketEquityOfferingProgramMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PlanNameDomain" xlink:type="locator" xlink:label="us-gaap_PlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PlanNameAxis" xlink:type="locator" xlink:label="us-gaap_PlanNameAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfStockByClassTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfStockByClassTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityAbstract" xlink:type="locator" xlink:label="us-gaap_EquityAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityAbstract" xlink:to="us-gaap_ScheduleOfStockByClassTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_PlanNameAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="akba_AtTheMarketEquityOfferingProgramMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="srt_RangeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_CommonStockMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_SubsidiarySaleOfStockAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsidiarySaleOfStockAxis" xlink:to="us-gaap_SaleOfStockNameOfTransactionDomain" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SaleOfStockNameOfTransactionDomain" xlink:to="akba_FollowOnPublicOfferingMember" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="srt_OwnershipAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipAxis" xlink:to="srt_OwnershipDomain" order="10520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_TypeOfArrangementAxis" order="10030.10" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TypeOfArrangementAxis" xlink:to="us-gaap_ArrangementsAndNonarrangementTransactionsMember" order="10740.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ArrangementsAndNonarrangementTransactionsMember" xlink:to="akba_MergerAgreementMember" order="10760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.12" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10960.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember" order="10980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="akba_ServiceBasedStockOptionsMember" order="11000.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="akba_PerformanceBasedStockOptionsMember" order="11020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockUnitsRSUMember" order="11040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="akba_ServiceBasedRestrictedStockUnitsMember" order="11060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="akba_InducementAwardProgramMember" order="11260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="akba_TwoThousandAndFourteenPlansMember" order="11360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember_li0l2" order="11500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockUnitsRSUMember_li0l2" order="11600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_TitleOfIndividualAxis" order="10030.14" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TitleOfIndividualAxis" xlink:to="us-gaap_TitleOfIndividualWithRelationshipToEntityDomain" order="11640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TitleOfIndividualWithRelationshipToEntityDomain" xlink:to="akba_EmployeesMember" order="11660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TitleOfIndividualWithRelationshipToEntityDomain" xlink:to="us-gaap_DirectorMember" order="11700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="akba_TwoThousandAndFourteenEmployeeStockPurchasePlanMember" order="11940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_VestingAxis" order="10030.16" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VestingAxis" xlink:to="us-gaap_VestingDomain" order="12220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VestingDomain" xlink:to="akba_ShareBasedCompensationAwardTrancheFirstAnniversaryOfGrantDateMember" order="12240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VestingDomain" xlink:to="us-gaap_ShareBasedCompensationAwardTrancheOneMember" order="12260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_VestingDomain" xlink:to="us-gaap_ShareBasedCompensationAwardTrancheTwoMember" order="12300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember_li0l2" order="12360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockMember" order="13320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TitleOfIndividualWithRelationshipToEntityDomain" xlink:to="akba_NonEmployeesMember" order="13480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="akba_StockOptionsAndRestrictedStockUnitsMember" order="14220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_ClassOfStockLineItems" order="14240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_CommonStockSharesAuthorized" order="14250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_CommonStockParOrStatedValuePerShare" order="14310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_CommonStockSharesIssued" order="14370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_CommonStockSharesOutstanding" order="14430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_PreferredStockSharesAuthorized" order="14490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_PreferredStockParOrStatedValuePerShare" order="14550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_PreferredStockSharesIssued" order="14610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_PreferredStockSharesOutstanding" order="14670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_CommonStockSalesAgreementAmount" order="14760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesNewIssues" order="14820.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ProceedsFromIssuanceOfCommonStockNetOfIssuanceCosts" order="14880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_SaleOfStockPricePerShare" order="14990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_StockholdersEquityNoteStockSplitConversionRatio1" order="15060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_BusinessAcquisitionEquityInterestsIssuedOrIssuableNumberOfSharesIssued" order="15080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_StockIssuedDuringPeriodSharesConversionOfConvertibleSecurities" order="15100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardConvertedOutstandingAndUnexercisedOptionsToPurchase" order="15120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsConvertedOutstandingOptions" order="15180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_AllocatedShareBasedCompensationExpense" order="15270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardNumberOfSharesAuthorized" order="15320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" order="15340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" order="15360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" order="15410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_AnnualIncreaseInAggregateNumberOfSharesReservedForFutureIssuanceAsPercentageSharesOutstanding" order="15430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" order="15510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAssumedInAcquiredShares" order="15530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAssumedInMerger" order="15550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardAdditionalSharesAuthorizedPercentageOfCommonStockIssued" order="15640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardMaximumNumberOfSharesOfOutstandingStock" order="15680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardPercentageOfOutstandingStockMaximum" order="15720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardPurchasePriceOfCommonStockPercent" order="15760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOfferingPeriod" order="15800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardSharesIssuedInPeriod" order="15870.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingPeriod1" order="15950.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardAwardVestingRightsPercentage" order="16030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardPeriodicVestingNumberOfInstallments" order="16270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardDescription" order="16350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardExpirationPeriod" order="16430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_AllocatedShareBasedCompensationGrantedExpense" order="16510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" order="16750.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" order="16810.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsVestedInPeriodFairValue1" order="16870.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedStockOptions" order="16930.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognizedPeriodForRecognition1" order="16990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" order="17100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardPotentialShareIssuablePercentage" order="17120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingRightsUponAchievementOfPerformanceConditionPercentage" order="17160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingRightsFollowingAchievementOfPerformanceConditionPercentage" order="17180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodAggregateWeightedAverageGrantDateFairValue" order="17700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsIssuedInMerger" order="18260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardAwardVestingRights" order="18280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNumberOfVestingInstallments" order="18300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationNonvestedAwardsTotalCompensationCostNotYetRecognized" order="18370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquitySummaryOfReservedSharesOfCommonStockForFutureIssuanceDetails" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquitySummaryOfReservedSharesOfCommonStockForFutureIssuanceDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquitySummaryOfReservedSharesOfCommonStockForFutureIssuanceDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" xlink:type="locator" xlink:label="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfStockLineItems" xlink:type="locator" xlink:label="us-gaap_ClassOfStockLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WarrantMember" xlink:type="locator" xlink:label="us-gaap_WarrantMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_EmployeeStockOptionAndRestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="akba_EmployeeStockOptionAndRestrictedStockUnitsRSUMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_TwoThousandAndFourteenPlansMember" xlink:type="locator" xlink:label="akba_TwoThousandAndFourteenPlansMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PlanNameDomain" xlink:type="locator" xlink:label="us-gaap_PlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PlanNameAxis" xlink:type="locator" xlink:label="us-gaap_PlanNameAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SaleOfStockNameOfTransactionDomain" xlink:type="locator" xlink:label="us-gaap_SaleOfStockNameOfTransactionDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsidiarySaleOfStockAxis" xlink:type="locator" xlink:label="us-gaap_SubsidiarySaleOfStockAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfStockByClassTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfStockByClassTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityAbstract" xlink:type="locator" xlink:label="us-gaap_EquityAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityAbstract" xlink:to="us-gaap_ScheduleOfStockByClassTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_SubsidiarySaleOfStockAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsidiarySaleOfStockAxis" xlink:to="us-gaap_SaleOfStockNameOfTransactionDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SaleOfStockNameOfTransactionDomain" xlink:to="us-gaap_EmployeeStockMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_PlanNameAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="akba_TwoThousandAndFourteenPlansMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="akba_EmployeeStockOptionAndRestrictedStockUnitsRSUMember" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_WarrantMember" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_ClassOfStockLineItems" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquitySummaryOfReservedSharesOfCommonStockForFutureIssuanceParentheticalDetails" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquitySummaryOfReservedSharesOfCommonStockForFutureIssuanceParentheticalDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquitySummaryOfReservedSharesOfCommonStockForFutureIssuanceParentheticalDetails">
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardMaximumNumberOfSharesAvailableForPurchase" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardMaximumNumberOfSharesAvailableForPurchase" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" xlink:type="locator" xlink:label="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" />
    <loc xlink:href="akba-20181231.xsd#akba_IncreaseDecreaseInCommonStockCapitalSharesReservedForFutureIssuance" xlink:type="locator" xlink:label="akba_IncreaseDecreaseInCommonStockCapitalSharesReservedForFutureIssuance" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfStockLineItems" xlink:type="locator" xlink:label="us-gaap_ClassOfStockLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SaleOfStockNameOfTransactionDomain" xlink:type="locator" xlink:label="us-gaap_SaleOfStockNameOfTransactionDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsidiarySaleOfStockAxis" xlink:type="locator" xlink:label="us-gaap_SubsidiarySaleOfStockAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsequentEventMember" xlink:type="locator" xlink:label="us-gaap_SubsequentEventMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsequentEventTypeDomain" xlink:type="locator" xlink:label="us-gaap_SubsequentEventTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsequentEventTypeAxis" xlink:type="locator" xlink:label="us-gaap_SubsequentEventTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_InducementAwardProgramMember" xlink:type="locator" xlink:label="akba_InducementAwardProgramMember" />
    <loc xlink:href="akba-20181231.xsd#akba_TwoThousandAndFourteenPlansMember" xlink:type="locator" xlink:label="akba_TwoThousandAndFourteenPlansMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PlanNameDomain" xlink:type="locator" xlink:label="us-gaap_PlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PlanNameAxis" xlink:type="locator" xlink:label="us-gaap_PlanNameAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfStockByClassTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfStockByClassTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityAbstract" xlink:type="locator" xlink:label="us-gaap_EquityAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityAbstract" xlink:to="us-gaap_ScheduleOfStockByClassTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_PlanNameAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="akba_TwoThousandAndFourteenPlansMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="akba_InducementAwardProgramMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_SubsequentEventTypeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeAxis" xlink:to="us-gaap_SubsequentEventTypeDomain" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsequentEventTypeDomain" xlink:to="us-gaap_SubsequentEventMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_SubsidiarySaleOfStockAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsidiarySaleOfStockAxis" xlink:to="us-gaap_SaleOfStockNameOfTransactionDomain" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SaleOfStockNameOfTransactionDomain" xlink:to="us-gaap_EmployeeStockMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_ClassOfStockLineItems" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_IncreaseDecreaseInCommonStockCapitalSharesReservedForFutureIssuance" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_CommonStockCapitalSharesReservedForFutureIssuance" order="10390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardMaximumNumberOfSharesAvailableForPurchase" order="10480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityScheduleOfAssumptionsUsedInBlackScholesOptionPricingModelDetails" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquityScheduleOfAssumptionsUsedInBlackScholesOptionPricingModelDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityScheduleOfAssumptionsUsedInBlackScholesOptionPricingModelDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardFairValueAssumptionsExpectedTerm1" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardFairValueAssumptionsExpectedTerm1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMaximum" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMaximum" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMinimum" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMinimum" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedDividendRate" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedDividendRate" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMaximum" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMaximum" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMinimum" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMinimum" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_TwoThousandAndFourteenPlansMember" xlink:type="locator" xlink:label="akba_TwoThousandAndFourteenPlansMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PlanNameDomain" xlink:type="locator" xlink:label="us-gaap_PlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PlanNameAxis" xlink:type="locator" xlink:label="us-gaap_PlanNameAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:type="locator" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_PlanNameAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameAxis" xlink:to="us-gaap_PlanNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PlanNameDomain" xlink:to="akba_TwoThousandAndFourteenPlansMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="srt_RangeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMinimum" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsRiskFreeInterestRateMaximum" order="10450.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedDividendRate" order="10630.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMinimum" order="10810.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardFairValueAssumptionsExpectedVolatilityRateMaximum" order="10990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardFairValueAssumptionsExpectedTerm1" order="11170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityScheduleOfStockOptionActivityDetails" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquityScheduleOfStockOptionActivityDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityScheduleOfStockOptionActivityDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestExercisableAggregateIntrinsicValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestExercisableAggregateIntrinsicValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeitedInPeriodIntrinsicValue" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeitedInPeriodIntrinsicValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGrantDateIntrinsicValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGrantDateIntrinsicValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementBySharesBasedPaymentAwardOptionsOutstandingAggregateIntrinsicValueRollforward" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementBySharesBasedPaymentAwardOptionsOutstandingAggregateIntrinsicValueRollforward" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageRemainingContractualTerm1" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageRemainingContractualTerm1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAdditionalDisclosuresAbstract" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAdditionalDisclosuresAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageExercisePrice" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageExercisePrice" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExpirationsInPeriodWeightedAverageExercisePrice" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExpirationsInPeriodWeightedAverageExercisePrice" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsForfeituresInPeriodWeightedAverageExercisePrice" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsForfeituresInPeriodWeightedAverageExercisePrice" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsAssumedInConnectionWithMergerWeightedAverageExercisePrice" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsAssumedInConnectionWithMergerWeightedAverageExercisePrice" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageExercisePrice" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageExercisePrice" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingNumber" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExpirationsInPeriod" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExpirationsInPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeituresInPeriod" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeituresInPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" xlink:type="locator" xlink:label="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAssumedInConnectionWithAcquiredShares" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAssumedInConnectionWithAcquiredShares" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfStockLineItems" xlink:type="locator" xlink:label="us-gaap_ClassOfStockLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockOptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfStockByClassTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfStockByClassTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:type="locator" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfStockByClassTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_ClassOfStockLineItems" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber" order="10490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGross" order="10590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAssumedInConnectionWithAcquiredShares" order="10690.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="us-gaap_StockIssuedDuringPeriodSharesStockOptionsExercised" order="10790.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeituresInPeriod" order="10890.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExpirationsInPeriod" order="10990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingNumber_li0l2" order="11090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableNumber" order="11190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingNumber" order="11290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" order="11420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice" order="11620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsGrantsInPeriodWeightedAverageExercisePrice" order="11720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="akba_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsAssumedInConnectionWithMergerWeightedAverageExercisePrice" order="11820.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExercisesInPeriodWeightedAverageExercisePrice" order="11920.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsForfeituresInPeriodWeightedAverageExercisePrice" order="12020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardOptionsExpirationsInPeriodWeightedAverageExercisePrice" order="12120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePrice_li0l2" order="12220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisableWeightedAverageExercisePrice" order="12320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingWeightedAverageExercisePriceRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageExercisePrice" order="12420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAdditionalDisclosuresAbstract" order="12550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAdditionalDisclosuresAbstract" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsOutstandingWeightedAverageRemainingContractualTerm2" order="12590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAdditionalDisclosuresAbstract" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableWeightedAverageRemainingContractualTerm1" order="12610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsAdditionalDisclosuresAbstract" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsVestedAndExpectedToVestOutstandingWeightedAverageRemainingContractualTerm1" order="12630.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementBySharesBasedPaymentAwardOptionsOutstandingAggregateIntrinsicValueRollforward" order="12680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_ShareBasedCompensationArrangementBySharesBasedPaymentAwardOptionsOutstandingAggregateIntrinsicValueRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsOutstandingIntrinsicValue" order="12880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_ShareBasedCompensationArrangementBySharesBasedPaymentAwardOptionsOutstandingAggregateIntrinsicValueRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsGrantsInPeriodGrantDateIntrinsicValue" order="12980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_ShareBasedCompensationArrangementBySharesBasedPaymentAwardOptionsOutstandingAggregateIntrinsicValueRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsExercisesInPeriodTotalIntrinsicValue" order="13080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_ShareBasedCompensationArrangementBySharesBasedPaymentAwardOptionsOutstandingAggregateIntrinsicValueRollforward" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsForfeitedInPeriodIntrinsicValue" order="13180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_ShareBasedCompensationArrangementBySharesBasedPaymentAwardOptionsOutstandingAggregateIntrinsicValueRollforward" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardOptionsExercisableIntrinsicValue1" order="13380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_ShareBasedCompensationArrangementBySharesBasedPaymentAwardOptionsOutstandingAggregateIntrinsicValueRollforward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardOptionsVestedAndExpectedToVestExercisableAggregateIntrinsicValue" order="13480.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityScheduleOfPerformanceBasedOptionActivityDetails" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquityScheduleOfPerformanceBasedOptionActivityDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityScheduleOfPerformanceBasedOptionActivityDetails">
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueForfeited" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueForfeited" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueExercised" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueExercised" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueGranted" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueGranted" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueOutstanding" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueOutstanding" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueAbstract" xlink:type="locator" xlink:label="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsOutstandingWeightedAverageRemainingContractualTerms" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsOutstandingWeightedAverageRemainingContractualTerms" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsWeightedAverageRemainingContractualTermAbstract" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsWeightedAverageRemainingContractualTermAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsExercisedWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsExercisedWeightedAverageGrantDateFairValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsExercisedInPeriod" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsExercisedInPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ClassOfStockLineItems" xlink:type="locator" xlink:label="us-gaap_ClassOfStockLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_PerformanceBasedStockOptionsMember" xlink:type="locator" xlink:label="akba_PerformanceBasedStockOptionsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfStockByClassTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfStockByClassTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:type="locator" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfStockByClassTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="akba_PerformanceBasedStockOptionsMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfStockByClassTable" xlink:to="us-gaap_ClassOfStockLineItems" order="10280.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" order="10490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" order="10590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsExercisedInPeriod" order="10690.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" order="10790.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_li0l2" order="10890.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward" order="11020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" order="11220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" order="11320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsExercisedWeightedAverageGrantDateFairValue" order="11420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" order="11520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValueRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_li0l2" order="11620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsWeightedAverageRemainingContractualTermAbstract" order="11750.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsWeightedAverageRemainingContractualTermAbstract" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsOutstandingWeightedAverageRemainingContractualTerms" order="11790.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ClassOfStockLineItems" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueAbstract" order="11840.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueAbstract" xlink:to="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueOutstanding" order="12040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueAbstract" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueGranted" order="12140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueAbstract" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueExercised" order="12240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SharebasedCompensationArrangementBySharebasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueAbstract" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsAggregateIntrinsicValueForfeited" order="12340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquitySummaryOfCompanyRestrictedStockActivityDetails" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquitySummaryOfCompanyRestrictedStockActivityDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquitySummaryOfCompanyRestrictedStockActivityDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsIssuedInMergerWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsIssuedInMergerWeightedAverageGrantDateFairValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_li0l2" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod" />
    <loc xlink:href="akba-20181231.xsd#akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsIssuedInMerger" xlink:type="locator" xlink:label="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsIssuedInMerger" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockUnitsRSUMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:type="locator" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockUnitsRSUMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfShareBasedCompensationArrangementsByShareBasedPaymentAwardTable" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardLineItems" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriod" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsIssuedInMerger" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriod" order="10470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeitedInPeriod" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedTerseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedNumber_li0l2" order="10590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue" order="10800.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodStartLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsGrantsInPeriodWeightedAverageGrantDateFairValue" order="10860.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="akba_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsIssuedInMergerWeightedAverageGrantDateFairValue" order="10920.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsVestedInPeriodWeightedAverageGrantDateFairValue" order="10980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsForfeituresWeightedAverageGrantDateFairValue" order="11040.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedRollForward" xlink:to="us-gaap_ShareBasedCompensationArrangementByShareBasedPaymentAwardEquityInstrumentsOtherThanOptionsNonvestedWeightedAverageGrantDateFairValue_li0l2" order="11100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/periodEndLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityCompensationCostRelatedToShareBasedAwardsDetails" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquityCompensationCostRelatedToShareBasedAwardsDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityCompensationCostRelatedToShareBasedAwardsDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AllocatedShareBasedCompensationExpense" xlink:type="locator" xlink:label="us-gaap_AllocatedShareBasedCompensationExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems" xlink:type="locator" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SellingGeneralAndAdministrativeExpensesMember" xlink:type="locator" xlink:label="us-gaap_SellingGeneralAndAdministrativeExpensesMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentExpenseMember" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentExpenseMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeStatementLocationDomain" xlink:type="locator" xlink:label="us-gaap_IncomeStatementLocationDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeStatementLocationAxis" xlink:type="locator" xlink:label="us-gaap_IncomeStatementLocationAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:type="locator" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" xlink:to="us-gaap_IncomeStatementLocationAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationAxis" xlink:to="us-gaap_IncomeStatementLocationDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationDomain" xlink:to="us-gaap_ResearchAndDevelopmentExpenseMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeStatementLocationDomain" xlink:to="us-gaap_SellingGeneralAndAdministrativeExpensesMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems" xlink:to="us-gaap_AllocatedShareBasedCompensationExpense" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityScheduleOfCompensationExpenseByTypeOfAwardDetails" xlink:href="akba-20181231.xsd#Role_DisclosureStockholdersEquityScheduleOfCompensationExpenseByTypeOfAwardDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureStockholdersEquityScheduleOfCompensationExpenseByTypeOfAwardDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AllocatedShareBasedCompensationExpense" xlink:type="locator" xlink:label="us-gaap_AllocatedShareBasedCompensationExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems" xlink:type="locator" xlink:label="us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WarrantMember" xlink:type="locator" xlink:label="us-gaap_WarrantMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EquityComponentDomain" xlink:type="locator" xlink:label="us-gaap_EquityComponentDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StatementEquityComponentsAxis" xlink:type="locator" xlink:label="us-gaap_StatementEquityComponentsAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockUnitsRSUMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockOptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:type="locator" xlink:label="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AwardTypeAxis" xlink:type="locator" xlink:label="us-gaap_AwardTypeAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SaleOfStockNameOfTransactionDomain" xlink:type="locator" xlink:label="us-gaap_SaleOfStockNameOfTransactionDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SubsidiarySaleOfStockAxis" xlink:type="locator" xlink:label="us-gaap_SubsidiarySaleOfStockAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:type="locator" xlink:label="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DisclosureOfCompensationRelatedCostsSharebasedPaymentsAbstract" xlink:to="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" xlink:to="us-gaap_SubsidiarySaleOfStockAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SubsidiarySaleOfStockAxis" xlink:to="us-gaap_SaleOfStockNameOfTransactionDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_SaleOfStockNameOfTransactionDomain" xlink:to="us-gaap_EmployeeStockMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" xlink:to="us-gaap_AwardTypeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AwardTypeAxis" xlink:to="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ShareBasedCompensationArrangementsByShareBasedPaymentAwardAwardTypeAndPlanNameDomain" xlink:to="us-gaap_RestrictedStockUnitsRSUMember" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" xlink:to="us-gaap_StatementEquityComponentsAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_StatementEquityComponentsAxis" xlink:to="us-gaap_EquityComponentDomain" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EquityComponentDomain" xlink:to="us-gaap_WarrantMember" order="10240.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfEmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsTable" xlink:to="us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EmployeeServiceShareBasedCompensationAllocationOfRecognizedPeriodCostsLineItems" xlink:to="us-gaap_AllocatedShareBasedCompensationExpense" order="10270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureIncomeTaxesAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" xlink:type="locator" xlink:label="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" />
    <loc xlink:href="akba-20181231.xsd#akba_LiabilityForUncertainTaxPositions" xlink:type="locator" xlink:label="akba_LiabilityForUncertainTaxPositions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OpenTaxYear" xlink:type="locator" xlink:label="us-gaap_OpenTaxYear" />
    <loc xlink:href="akba-20181231.xsd#akba_IncreaseDecreaseInDeferredTaxAssets" xlink:type="locator" xlink:label="akba_IncreaseDecreaseInDeferredTaxAssets" />
    <loc xlink:href="akba-20181231.xsd#akba_TermOfChangeInOwnershipOfStockholders" xlink:type="locator" xlink:label="akba_TermOfChangeInOwnershipOfStockholders" />
    <loc xlink:href="akba-20181231.xsd#akba_PercentageOfChangeInOwnershipOfStockholdersHoldingOutstandingStock" xlink:type="locator" xlink:label="akba_PercentageOfChangeInOwnershipOfStockholdersHoldingOutstandingStock" />
    <loc xlink:href="akba-20181231.xsd#akba_PercentageOfChangeInOwnershipOfStockholders" xlink:type="locator" xlink:label="akba_PercentageOfChangeInOwnershipOfStockholders" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxCreditCarryforwardsResearch" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsTaxCreditCarryforwardsResearch" />
    <loc xlink:href="akba-20181231.xsd#akba_TaxCutsAndJobsActOf2017OperatingLossCarryForwardsIndefinitely" xlink:type="locator" xlink:label="akba_TaxCutsAndJobsActOf2017OperatingLossCarryForwardsIndefinitely" />
    <loc xlink:href="akba-20181231.xsd#akba_OperatingLossCarryforwardsExpirationYear" xlink:type="locator" xlink:label="akba_OperatingLossCarryforwardsExpirationYear" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLossCarryforwards" xlink:type="locator" xlink:label="us-gaap_OperatingLossCarryforwards" />
    <loc xlink:href="akba-20181231.xsd#akba_DeferredIncomeTaxAmortization" xlink:type="locator" xlink:label="akba_DeferredIncomeTaxAmortization" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CapitalizedContractCostNet" xlink:type="locator" xlink:label="us-gaap_CapitalizedContractCostNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ValuationAllowanceDeferredTaxAssetChangeInAmount" xlink:type="locator" xlink:label="us-gaap_ValuationAllowanceDeferredTaxAssetChangeInAmount" />
    <loc xlink:href="akba-20181231.xsd#akba_AlternativeMinimumTaxReceivable" xlink:type="locator" xlink:label="akba_AlternativeMinimumTaxReceivable" />
    <loc xlink:href="akba-20181231.xsd#akba_AlternativeMinimumTaxPayable" xlink:type="locator" xlink:label="akba_AlternativeMinimumTaxPayable" />
    <loc xlink:href="akba-20181231.xsd#akba_TaxCutsAndJobsActOf2017ChangeInTaxRateReductionInDeferredTaxAsset" xlink:type="locator" xlink:label="akba_TaxCutsAndJobsActOf2017ChangeInTaxRateReductionInDeferredTaxAsset" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_IncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredIncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentIncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_CurrentIncomeTaxExpenseBenefit" />
    <loc xlink:href="akba-20181231.xsd#akba_IncomeTaxDisclosureLineItems" xlink:type="locator" xlink:label="akba_IncomeTaxDisclosureLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxYear2015Member" xlink:type="locator" xlink:label="us-gaap_TaxYear2015Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxYear2016Member" xlink:type="locator" xlink:label="us-gaap_TaxYear2016Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxYear2017Member" xlink:type="locator" xlink:label="us-gaap_TaxYear2017Member" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxPeriodDomain" xlink:type="locator" xlink:label="us-gaap_TaxPeriodDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_TaxPeriodAxis" xlink:type="locator" xlink:label="us-gaap_TaxPeriodAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_FederalAndStateMember" xlink:type="locator" xlink:label="akba_FederalAndStateMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_StateAndLocalJurisdictionMember" xlink:type="locator" xlink:label="us-gaap_StateAndLocalJurisdictionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DomesticCountryMember" xlink:type="locator" xlink:label="us-gaap_DomesticCountryMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxAuthorityDomain" xlink:type="locator" xlink:label="us-gaap_IncomeTaxAuthorityDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxAuthorityAxis" xlink:type="locator" xlink:label="us-gaap_IncomeTaxAuthorityAxis" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MinimumMember" xlink:type="locator" xlink:label="srt_MinimumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_MaximumMember" xlink:type="locator" xlink:label="srt_MaximumMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeMember" xlink:type="locator" xlink:label="srt_RangeMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RangeAxis" xlink:type="locator" xlink:label="srt_RangeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAcquireeDomain" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionAcquireeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BusinessAcquisitionAxis" xlink:type="locator" xlink:label="us-gaap_BusinessAcquisitionAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_IncomeTaxDisclosureTable" xlink:type="locator" xlink:label="akba_IncomeTaxDisclosureTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_IncomeTaxDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="akba_IncomeTaxDisclosureTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureTable" xlink:to="us-gaap_BusinessAcquisitionAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAxis" xlink:to="us-gaap_BusinessAcquisitionAcquireeDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BusinessAcquisitionAcquireeDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureTable" xlink:to="srt_RangeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeAxis" xlink:to="srt_RangeMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MaximumMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RangeMember" xlink:to="srt_MinimumMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureTable" xlink:to="us-gaap_IncomeTaxAuthorityAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityAxis" xlink:to="us-gaap_IncomeTaxAuthorityDomain" order="10200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityDomain" xlink:to="us-gaap_DomesticCountryMember" order="10220.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityDomain" xlink:to="us-gaap_StateAndLocalJurisdictionMember" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxAuthorityDomain" xlink:to="akba_FederalAndStateMember" order="10520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureTable" xlink:to="us-gaap_TaxPeriodAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TaxPeriodAxis" xlink:to="us-gaap_TaxPeriodDomain" order="10600.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TaxPeriodDomain" xlink:to="us-gaap_TaxYear2017Member" order="10620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TaxPeriodDomain" xlink:to="us-gaap_TaxYear2016Member" order="10640.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_TaxPeriodDomain" xlink:to="us-gaap_TaxYear2015Member" order="10660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureTable" xlink:to="akba_IncomeTaxDisclosureLineItems" order="10680.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_CurrentIncomeTaxExpenseBenefit" order="10690.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_DeferredIncomeTaxExpenseBenefit" order="10750.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="10810.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" order="10900.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_TaxCutsAndJobsActOf2017ChangeInTaxRateReductionInDeferredTaxAsset" order="11010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_AlternativeMinimumTaxPayable" order="11060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_AlternativeMinimumTaxReceivable" order="11080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_ValuationAllowanceDeferredTaxAssetChangeInAmount" order="11130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_CapitalizedContractCostNet" order="11200.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_DeferredIncomeTaxAmortization" order="11300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_OperatingLossCarryforwards" order="11400.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_OperatingLossCarryforwardsExpirationYear" order="11500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_TaxCutsAndJobsActOf2017OperatingLossCarryForwardsIndefinitely" order="11700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_DeferredTaxAssetsTaxCreditCarryforwardsResearch" order="12000.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_PercentageOfChangeInOwnershipOfStockholders" order="12230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_PercentageOfChangeInOwnershipOfStockholdersHoldingOutstandingStock" order="12250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_TermOfChangeInOwnershipOfStockholders" order="12270.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_IncreaseDecreaseInDeferredTaxAssets" order="12290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_OpenTaxYear" order="12340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="akba_LiabilityForUncertainTaxPositions" order="12430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_IncomeTaxDisclosureLineItems" xlink:to="us-gaap_IncomeTaxExaminationPenaltiesAndInterestAccrued" order="12490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesScheduleOfProvisionForIncomeTaxesDetails" xlink:href="akba-20181231.xsd#Role_DisclosureIncomeTaxesScheduleOfProvisionForIncomeTaxesDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesScheduleOfProvisionForIncomeTaxesDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_IncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredIncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_DeferredIncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredFederalIncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_DeferredFederalIncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredFederalStateAndLocalTaxExpenseBenefitAbstract" xlink:type="locator" xlink:label="us-gaap_DeferredFederalStateAndLocalTaxExpenseBenefitAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentIncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_CurrentIncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentStateAndLocalTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_CurrentStateAndLocalTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentFederalTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_CurrentFederalTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CurrentFederalStateAndLocalTaxExpenseBenefitAbstract" xlink:type="locator" xlink:label="us-gaap_CurrentFederalStateAndLocalTaxExpenseBenefitAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_IncomeTaxDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_CurrentFederalStateAndLocalTaxExpenseBenefitAbstract" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CurrentFederalStateAndLocalTaxExpenseBenefitAbstract" xlink:to="us-gaap_CurrentFederalTaxExpenseBenefit" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CurrentFederalStateAndLocalTaxExpenseBenefitAbstract" xlink:to="us-gaap_CurrentStateAndLocalTaxExpenseBenefit" order="10250.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CurrentFederalStateAndLocalTaxExpenseBenefitAbstract" xlink:to="us-gaap_CurrentIncomeTaxExpenseBenefit" order="10310.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredFederalStateAndLocalTaxExpenseBenefitAbstract" order="10370.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredFederalStateAndLocalTaxExpenseBenefitAbstract" xlink:to="us-gaap_DeferredFederalIncomeTaxExpenseBenefit" order="10490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredFederalStateAndLocalTaxExpenseBenefitAbstract" xlink:to="us-gaap_DeferredStateAndLocalIncomeTaxExpenseBenefit" order="10550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredFederalStateAndLocalTaxExpenseBenefitAbstract" xlink:to="us-gaap_DeferredIncomeTaxExpenseBenefit" order="10610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredFederalStateAndLocalTaxExpenseBenefitAbstract" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="10670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesScheduleOfEffectiveIncomeTaxRateDiffersFromStatutoryFederalIncomeTaxRateDetails" xlink:href="akba-20181231.xsd#Role_DisclosureIncomeTaxesScheduleOfEffectiveIncomeTaxRateDiffersFromStatutoryFederalIncomeTaxRateDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesScheduleOfEffectiveIncomeTaxRateDiffersFromStatutoryFederalIncomeTaxRateDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateContinuingOperations" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateContinuingOperations" />
    <loc xlink:href="akba-20181231.xsd#akba_EffectiveIncomeTaxRateReconciliationIncreaseDecreaseInDeferredTaxAssetsDueToChangeInOwnership" xlink:type="locator" xlink:label="akba_EffectiveIncomeTaxRateReconciliationIncreaseDecreaseInDeferredTaxAssetsDueToChangeInOwnership" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance" />
    <loc xlink:href="akba-20181231.xsd#akba_EffectiveIncomeTaxReconciliationAlternativeMinimumTax" xlink:type="locator" xlink:label="akba_EffectiveIncomeTaxReconciliationAlternativeMinimumTax" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpenseShareBasedCompensationCost" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpenseShareBasedCompensationCost" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationTaxCreditsResearch" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationTaxCreditsResearch" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" xlink:type="locator" xlink:label="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_IncomeTaxDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationAtFederalStatutoryIncomeTaxRate" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationStateAndLocalIncomeTaxes" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationTaxCreditsResearch" order="10230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpenseShareBasedCompensationCost" order="10290.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="akba_EffectiveIncomeTaxReconciliationAlternativeMinimumTax" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInDeferredTaxAssetsValuationAllowance" order="10410.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationChangeInEnactedTaxRate" order="10470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationNondeductibleExpense" order="10530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateReconciliationOtherReconcilingItemsPercent" order="10590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="akba_EffectiveIncomeTaxRateReconciliationIncreaseDecreaseInDeferredTaxAssetsDueToChangeInOwnership" order="10650.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_EffectiveIncomeTaxRateContinuingOperations" order="10710.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesScheduleOfSignificantDeferredTaxAssetsAndLiabilitiesDetails" xlink:href="akba-20181231.xsd#Role_DisclosureIncomeTaxesScheduleOfSignificantDeferredTaxAssetsAndLiabilitiesDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureIncomeTaxesScheduleOfSignificantDeferredTaxAssetsAndLiabilitiesDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsLiabilitiesNet" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsLiabilitiesNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilities" xlink:type="locator" xlink:label="us-gaap_DeferredTaxLiabilities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredIncomeTaxLiabilities" xlink:type="locator" xlink:label="us-gaap_DeferredIncomeTaxLiabilities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesDeferredExpenseCapitalizedInventoryCosts" xlink:type="locator" xlink:label="us-gaap_DeferredTaxLiabilitiesDeferredExpenseCapitalizedInventoryCosts" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" xlink:type="locator" xlink:label="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesPropertyPlantAndEquipment" xlink:type="locator" xlink:label="us-gaap_DeferredTaxLiabilitiesPropertyPlantAndEquipment" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxLiabilitiesAbstract" xlink:type="locator" xlink:label="us-gaap_DeferredTaxLiabilitiesAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsNet" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsNet" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsValuationAllowanceNoncurrent" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsValuationAllowanceNoncurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsGross" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsGross" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOther" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsOther" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" />
    <loc xlink:href="akba-20181231.xsd#akba_DeferredTaxAssetsOtherNonCurrentLiabilities" xlink:type="locator" xlink:label="akba_DeferredTaxAssetsOtherNonCurrentLiabilities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxCreditCarryforwardsResearch" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsTaxCreditCarryforwardsResearch" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsGoodwillAndIntangibleAssets" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsGoodwillAndIntangibleAssets" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsDeferredIncome" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsDeferredIncome" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAccruedLiabilities" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAccruedLiabilities" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DeferredTaxAssetsNetAbstract" xlink:type="locator" xlink:label="us-gaap_DeferredTaxAssetsNetAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_IncomeTaxDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsNetAbstract" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseReservesAndAccrualsAccruedLiabilities" order="10260.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsDeferredIncome" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsGoodwillAndIntangibleAssets" order="10340.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxDeferredExpenseCompensationAndBenefitsShareBasedCompensationCost" order="10380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsTaxCreditCarryforwardsResearch" order="10420.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="akba_DeferredTaxAssetsOtherNonCurrentLiabilities" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsOperatingLossCarryforwards" order="10500.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsOther" order="10540.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsGross" order="10580.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsValuationAllowanceNoncurrent" order="10620.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxAssetsNetAbstract" xlink:to="us-gaap_DeferredTaxAssetsNet" order="10660.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesAbstract" order="10700.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesPropertyPlantAndEquipment" order="10780.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesGoodwillAndIntangibleAssetsIntangibleAssets" order="10820.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="us-gaap_DeferredTaxLiabilitiesDeferredExpenseCapitalizedInventoryCosts" order="10860.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_DeferredTaxLiabilitiesAbstract" xlink:to="us-gaap_DeferredIncomeTaxLiabilities" order="10900.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedTotalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxLiabilities" order="10940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2009/role/negatedTotalLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_IncomeTaxDisclosureAbstract" xlink:to="us-gaap_DeferredTaxAssetsLiabilitiesNet" order="11360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureEmployeeRetirementPlanAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureEmployeeRetirementPlanAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureEmployeeRetirementPlanAdditionalInformationDetails">
    <loc xlink:href="akba-20181231.xsd#akba_DefinedContributionPlanEmployeesAgeToBeEligibleUnderPlan" xlink:type="locator" xlink:label="akba_DefinedContributionPlanEmployeesAgeToBeEligibleUnderPlan" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_DefinedContributionPlanEmployerDiscretionaryContributionAmount" xlink:type="locator" xlink:label="us-gaap_DefinedContributionPlanEmployerDiscretionaryContributionAmount" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_CompensationAndRetirementDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:to="us-gaap_DefinedContributionPlanEmployerDiscretionaryContributionAmount" order="10010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CompensationAndRetirementDisclosureAbstract" xlink:to="akba_DefinedContributionPlanEmployeesAgeToBeEligibleUnderPlan" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformationDetails" xlink:href="akba-20181231.xsd#Role_DisclosureCommitmentsAndContingenciesAdditionalInformationDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureCommitmentsAndContingenciesAdditionalInformationDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersCostsIncurredGross" xlink:type="locator" xlink:label="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersCostsIncurredGross" />
    <loc xlink:href="akba-20181231.xsd#akba_PurchaseCommittedProgramRemainingContractCosts" xlink:type="locator" xlink:label="akba_PurchaseCommittedProgramRemainingContractCosts" />
    <loc xlink:href="akba-20181231.xsd#akba_AgreementEarlyTermination" xlink:type="locator" xlink:label="akba_AgreementEarlyTermination" />
    <loc xlink:href="akba-20181231.xsd#akba_AgreementRenewalTermTermination" xlink:type="locator" xlink:label="akba_AgreementRenewalTermTermination" />
    <loc xlink:href="akba-20181231.xsd#akba_AgreementExpirationDate" xlink:type="locator" xlink:label="akba_AgreementExpirationDate" />
    <loc xlink:href="akba-20181231.xsd#akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesFairValueOfOffMarketElement" xlink:type="locator" xlink:label="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesFairValueOfOffMarketElement" />
    <loc xlink:href="akba-20181231.xsd#akba_CostOfPurchasedMinimumQuantityProduct" xlink:type="locator" xlink:label="akba_CostOfPurchasedMinimumQuantityProduct" />
    <loc xlink:href="akba-20181231.xsd#akba_DescriptionOfTerminationOfAgreementPriorToContractTerm" xlink:type="locator" xlink:label="akba_DescriptionOfTerminationOfAgreementPriorToContractTerm" />
    <loc xlink:href="akba-20181231.xsd#akba_AgreementExpirationYear" xlink:type="locator" xlink:label="akba_AgreementExpirationYear" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LeaseAndRentalExpense" xlink:type="locator" xlink:label="us-gaap_LeaseAndRentalExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_SecurityDeposit" xlink:type="locator" xlink:label="us-gaap_SecurityDeposit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncreaseDecreaseInSecurityDeposits" xlink:type="locator" xlink:label="us-gaap_IncreaseDecreaseInSecurityDeposits" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LessorOperatingLeaseRenewalTerm" xlink:type="locator" xlink:label="us-gaap_LessorOperatingLeaseRenewalTerm" />
    <loc xlink:href="akba-20181231.xsd#akba_LesseeLeasingArrangementsOperatingLeasesNumberOfLeasePeriodExtensionOptions" xlink:type="locator" xlink:label="akba_LesseeLeasingArrangementsOperatingLeasesNumberOfLeasePeriodExtensionOptions" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LeaseExpirationDate1" xlink:type="locator" xlink:label="us-gaap_LeaseExpirationDate1" />
    <loc xlink:href="akba-20181231.xsd#akba_LeaseholdImprovementAllowanceNotYetUsed" xlink:type="locator" xlink:label="akba_LeaseholdImprovementAllowanceNotYetUsed" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncentiveFromLessor" xlink:type="locator" xlink:label="us-gaap_IncentiveFromLessor" />
    <loc xlink:href="akba-20181231.xsd#akba_LeaseExpirationMonthYear" xlink:type="locator" xlink:label="akba_LeaseExpirationMonthYear" />
    <loc xlink:href="akba-20181231.xsd#akba_LeasedPropertySubjectToAnnualRentEscalationsCommencementDate" xlink:type="locator" xlink:label="akba_LeasedPropertySubjectToAnnualRentEscalationsCommencementDate" />
    <loc xlink:href="akba-20181231.xsd#akba_LeasedPropertyDeliveredDate" xlink:type="locator" xlink:label="akba_LeasedPropertyDeliveredDate" />
    <loc xlink:href="akba-20181231.xsd#akba_OperatingLeasePaymentsCommencementDate" xlink:type="locator" xlink:label="akba_OperatingLeasePaymentsCommencementDate" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesRentExpenseMinimumRentals" xlink:type="locator" xlink:label="us-gaap_OperatingLeasesRentExpenseMinimumRentals" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AreaOfRealEstateProperty" xlink:type="locator" xlink:label="us-gaap_AreaOfRealEstateProperty" />
    <loc xlink:href="akba-20181231.xsd#akba_CommitmentsAndContingenciesLineItems" xlink:type="locator" xlink:label="akba_CommitmentsAndContingenciesLineItems" />
    <loc xlink:href="akba-20181231.xsd#akba_SiegfriedEvionnazSAMember" xlink:type="locator" xlink:label="akba_SiegfriedEvionnazSAMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipDomain" xlink:type="locator" xlink:label="srt_OwnershipDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_OwnershipAxis" xlink:type="locator" xlink:label="srt_OwnershipAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_BioVectraIncMember" xlink:type="locator" xlink:label="akba_BioVectraIncMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_RepurchaseAgreementCounterpartyNameDomain" xlink:type="locator" xlink:label="srt_RepurchaseAgreementCounterpartyNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_CounterpartyNameAxis" xlink:type="locator" xlink:label="srt_CounterpartyNameAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OtherCurrentAssetsMember" xlink:type="locator" xlink:label="us-gaap_OtherCurrentAssetsMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationDomain" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_BalanceSheetLocationAxis" xlink:type="locator" xlink:label="us-gaap_BalanceSheetLocationAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LetterOfCreditMember" xlink:type="locator" xlink:label="us-gaap_LetterOfCreditMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CreditFacilityDomain" xlink:type="locator" xlink:label="us-gaap_CreditFacilityDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CreditFacilityAxis" xlink:type="locator" xlink:label="us-gaap_CreditFacilityAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_KeryxBiopharmaceuticalsIncMember" xlink:type="locator" xlink:label="akba_KeryxBiopharmaceuticalsIncMember" />
    <loc xlink:href="akba-20181231.xsd#akba_LabSpaceMember" xlink:type="locator" xlink:label="akba_LabSpaceMember" />
    <loc xlink:href="akba-20181231.xsd#akba_BostonLeaseMember" xlink:type="locator" xlink:label="akba_BostonLeaseMember" />
    <loc xlink:href="akba-20181231.xsd#akba_OfficeSpaceMember" xlink:type="locator" xlink:label="akba_OfficeSpaceMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:type="locator" xlink:label="us-gaap_PropertyPlantAndEquipmentByTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_FifthAmendmentToCambridgeLeaseMember" xlink:type="locator" xlink:label="akba_FifthAmendmentToCambridgeLeaseMember" />
    <loc xlink:href="akba-20181231.xsd#akba_LeaseMonthlyPaymentsOnOrAboutJanuary12017Member" xlink:type="locator" xlink:label="akba_LeaseMonthlyPaymentsOnOrAboutJanuary12017Member" />
    <loc xlink:href="akba-20181231.xsd#akba_ThirdAmendmentToCambridgeLeaseMember" xlink:type="locator" xlink:label="akba_ThirdAmendmentToCambridgeLeaseMember" />
    <loc xlink:href="akba-20181231.xsd#akba_LeaseAmendmentMember" xlink:type="locator" xlink:label="akba_LeaseAmendmentMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LeaseArrangementTypeDomain" xlink:type="locator" xlink:label="us-gaap_LeaseArrangementTypeDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LeaseArrangementTypeAxis" xlink:type="locator" xlink:label="us-gaap_LeaseArrangementTypeAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_CommitmentsAndContingenciesTable" xlink:type="locator" xlink:label="akba_CommitmentsAndContingenciesTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="akba_CommitmentsAndContingenciesTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesTable" xlink:to="us-gaap_LeaseArrangementTypeAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LeaseArrangementTypeAxis" xlink:to="us-gaap_LeaseArrangementTypeDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LeaseArrangementTypeDomain" xlink:to="akba_LeaseAmendmentMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LeaseArrangementTypeDomain" xlink:to="akba_ThirdAmendmentToCambridgeLeaseMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LeaseArrangementTypeDomain" xlink:to="akba_LeaseMonthlyPaymentsOnOrAboutJanuary12017Member" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LeaseArrangementTypeDomain" xlink:to="akba_FifthAmendmentToCambridgeLeaseMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesTable" xlink:to="us-gaap_PropertyPlantAndEquipmentByTypeAxis" order="10030.02" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentByTypeAxis" xlink:to="us-gaap_PropertyPlantAndEquipmentTypeDomain" order="10300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="akba_OfficeSpaceMember" order="10320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LeaseArrangementTypeDomain" xlink:to="akba_BostonLeaseMember" order="10460.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_PropertyPlantAndEquipmentTypeDomain" xlink:to="akba_LabSpaceMember" order="10720.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_LeaseArrangementTypeDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="10880.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesTable" xlink:to="us-gaap_CreditFacilityAxis" order="10030.04" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityAxis" xlink:to="us-gaap_CreditFacilityDomain" order="10980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CreditFacilityDomain" xlink:to="us-gaap_LetterOfCreditMember" order="11000.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesTable" xlink:to="us-gaap_BalanceSheetLocationAxis" order="10030.06" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationAxis" xlink:to="us-gaap_BalanceSheetLocationDomain" order="11140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_BalanceSheetLocationDomain" xlink:to="us-gaap_OtherCurrentAssetsMember" order="11160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesTable" xlink:to="srt_CounterpartyNameAxis" order="10030.08" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_CounterpartyNameAxis" xlink:to="srt_RepurchaseAgreementCounterpartyNameDomain" order="11300.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_BioVectraIncMember" order="11320.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesTable" xlink:to="srt_OwnershipAxis" order="10030.10" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipAxis" xlink:to="srt_OwnershipDomain" order="11360.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_OwnershipDomain" xlink:to="akba_KeryxBiopharmaceuticalsIncMember" order="11380.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_RepurchaseAgreementCounterpartyNameDomain" xlink:to="akba_SiegfriedEvionnazSAMember" order="11440.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesTable" xlink:to="akba_CommitmentsAndContingenciesLineItems" order="11520.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="us-gaap_AreaOfRealEstateProperty" order="11530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="us-gaap_OperatingLeasesRentExpenseMinimumRentals" order="11570.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_OperatingLeasePaymentsCommencementDate" order="11610.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_LeasedPropertyDeliveredDate" order="11810.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_LeasedPropertySubjectToAnnualRentEscalationsCommencementDate" order="11890.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_LeaseExpirationMonthYear" order="11980.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="us-gaap_IncentiveFromLessor" order="12050.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_LeaseholdImprovementAllowanceNotYetUsed" order="12090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="us-gaap_LeaseExpirationDate1" order="12130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_LesseeLeasingArrangementsOperatingLeasesNumberOfLeasePeriodExtensionOptions" order="12170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="us-gaap_LessorOperatingLeaseRenewalTerm" order="12210.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="us-gaap_IncreaseDecreaseInSecurityDeposits" order="12490.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="us-gaap_SecurityDeposit" order="12530.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="us-gaap_LeaseAndRentalExpense" order="12760.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_AgreementExpirationYear" order="12850.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_DescriptionOfTerminationOfAgreementPriorToContractTerm" order="12870.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_CostOfPurchasedMinimumQuantityProduct" order="12890.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_BusinessCombinationRecognizedIdentifiableAssetsAcquiredAndLiabilitiesAssumedNoncurrentLiabilitiesFairValueOfOffMarketElement" order="12940.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_AgreementExpirationDate" order="12990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_AgreementRenewalTermTermination" order="13010.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_AgreementEarlyTermination" order="13030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="akba_PurchaseCommittedProgramRemainingContractCosts" order="13100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_CommitmentsAndContingenciesLineItems" xlink:to="us-gaap_ResearchAndDevelopmentArrangementContractToPerformForOthersCostsIncurredGross" order="13120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumPaymentsRequiredUnderLeasesDetails" xlink:href="akba-20181231.xsd#Role_DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumPaymentsRequiredUnderLeasesDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureCommitmentsAndContingenciesScheduleOfFutureMinimumPaymentsRequiredUnderLeasesDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDue" xlink:type="locator" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" xlink:type="locator" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" xlink:type="locator" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" xlink:type="locator" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" xlink:type="locator" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" xlink:type="locator" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" xlink:type="locator" xlink:label="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueCurrent" order="10070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInTwoYears" order="10090.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInThreeYears" order="10110.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFourYears" order="10130.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueInFiveYears" order="10150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDueThereafter" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_CommitmentsAndContingenciesDisclosureAbstract" xlink:to="us-gaap_OperatingLeasesFutureMinimumPaymentsDue" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/totalLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureNetLossPerShareAntiDilutiveSecuritiesExcludedFromCalculationOfDilutedNetLossPerShareDetails" xlink:href="akba-20181231.xsd#Role_DisclosureNetLossPerShareAntiDilutiveSecuritiesExcludedFromCalculationOfDilutedNetLossPerShareDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureNetLossPerShareAntiDilutiveSecuritiesExcludedFromCalculationOfDilutedNetLossPerShareDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" xlink:type="locator" xlink:label="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareLineItems" xlink:type="locator" xlink:label="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockUnitsRSUMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockUnitsRSUMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RestrictedStockMember" xlink:type="locator" xlink:label="us-gaap_RestrictedStockMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EmployeeStockOptionMember" xlink:type="locator" xlink:label="us-gaap_EmployeeStockOptionMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WarrantMember" xlink:type="locator" xlink:label="us-gaap_WarrantMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AntidilutiveSecuritiesNameDomain" xlink:type="locator" xlink:label="us-gaap_AntidilutiveSecuritiesNameDomain" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareByAntidilutiveSecuritiesAxis" xlink:type="locator" xlink:label="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareByAntidilutiveSecuritiesAxis" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ScheduleOfAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareTable" xlink:type="locator" xlink:label="us-gaap_ScheduleOfAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareAbstract" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareAbstract" xlink:to="us-gaap_ScheduleOfAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareTable" xlink:to="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareByAntidilutiveSecuritiesAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareByAntidilutiveSecuritiesAxis" xlink:to="us-gaap_AntidilutiveSecuritiesNameDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AntidilutiveSecuritiesNameDomain" xlink:to="us-gaap_WarrantMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AntidilutiveSecuritiesNameDomain" xlink:to="us-gaap_EmployeeStockOptionMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AntidilutiveSecuritiesNameDomain" xlink:to="us-gaap_RestrictedStockMember" order="10120.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AntidilutiveSecuritiesNameDomain" xlink:to="us-gaap_RestrictedStockUnitsRSUMember" order="10140.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_ScheduleOfAntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareTable" xlink:to="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareLineItems" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareLineItems" xlink:to="us-gaap_AntidilutiveSecuritiesExcludedFromComputationOfEarningsPerShareAmount" order="10170.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
  <roleRef roleURI="http://akebia.com/20181231/taxonomy/role/DisclosureQuarterlyResultsUnauditedDetails" xlink:href="akba-20181231.xsd#Role_DisclosureQuarterlyResultsUnauditedDetails" xlink:type="simple" />
  <presentationLink xlink:type="extended" xlink:role="http://akebia.com/20181231/taxonomy/role/DisclosureQuarterlyResultsUnauditedDetails">
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" xlink:type="locator" xlink:label="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" xlink:type="locator" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfShareOutstandingBasicAndDiluted" xlink:type="locator" xlink:label="us-gaap_WeightedAverageNumberOfShareOutstandingBasicAndDiluted" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_WeightedAverageNumberOfSharesOutstandingDilutedDisclosureItemsAbstract" xlink:type="locator" xlink:label="us-gaap_WeightedAverageNumberOfSharesOutstandingDilutedDisclosureItemsAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareDiluted" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareDiluted" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasic" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareBasic" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasicAndDiluted" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareBasicAndDiluted" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_EarningsPerShareBasicAndDilutedAbstract" xlink:type="locator" xlink:label="us-gaap_EarningsPerShareBasicAndDilutedAbstract" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NetIncomeLoss" xlink:type="locator" xlink:label="us-gaap_NetIncomeLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_IncomeTaxExpenseBenefit" xlink:type="locator" xlink:label="us-gaap_IncomeTaxExpenseBenefit" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_NonoperatingIncomeExpense" xlink:type="locator" xlink:label="us-gaap_NonoperatingIncomeExpense" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingIncomeLoss" xlink:type="locator" xlink:label="us-gaap_OperatingIncomeLoss" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_OperatingExpenses" xlink:type="locator" xlink:label="us-gaap_OperatingExpenses" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_CostOfRevenue" xlink:type="locator" xlink:label="us-gaap_CostOfRevenue" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" xlink:type="locator" xlink:label="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" />
    <loc xlink:href="akba-20181231.xsd#akba_QuarterlyFinancialInformationLineItems" xlink:type="locator" xlink:label="akba_QuarterlyFinancialInformationLineItems" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_LicenseAndServiceMember" xlink:type="locator" xlink:label="us-gaap_LicenseAndServiceMember" />
    <loc xlink:href="akba-20181231.xsd#akba_LicenseCollaborationAndOtherRevenueMember" xlink:type="locator" xlink:label="akba_LicenseCollaborationAndOtherRevenueMember" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_ProductMember" xlink:type="locator" xlink:label="us-gaap_ProductMember" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductsAndServicesDomain" xlink:type="locator" xlink:label="srt_ProductsAndServicesDomain" />
    <loc xlink:href="http://xbrl.fasb.org/srt/2018/elts/srt-2018-01-31.xsd#srt_ProductOrServiceAxis" xlink:type="locator" xlink:label="srt_ProductOrServiceAxis" />
    <loc xlink:href="akba-20181231.xsd#akba_QuarterlyFinancialInformationTable" xlink:type="locator" xlink:label="akba_QuarterlyFinancialInformationTable" />
    <loc xlink:href="http://xbrl.fasb.org/us-gaap/2018/elts/us-gaap-2018-01-31.xsd#us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:type="locator" xlink:label="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_QuarterlyFinancialInformationDisclosureAbstract" xlink:to="akba_QuarterlyFinancialInformationTable" order="10020.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationTable" xlink:to="srt_ProductOrServiceAxis" order="10030.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductOrServiceAxis" xlink:to="srt_ProductsAndServicesDomain" order="10060.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_ProductMember" order="10080.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="akba_LicenseCollaborationAndOtherRevenueMember" order="10100.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="srt_ProductsAndServicesDomain" xlink:to="us-gaap_LicenseAndServiceMember" order="10160.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationTable" xlink:to="akba_QuarterlyFinancialInformationLineItems" order="10180.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationLineItems" xlink:to="us-gaap_RevenueFromContractWithCustomerExcludingAssessedTax" order="10190.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationLineItems" xlink:to="us-gaap_CostOfRevenue" order="10350.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationLineItems" xlink:to="us-gaap_OperatingExpenses" order="10430.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationLineItems" xlink:to="us-gaap_OperatingIncomeLoss" order="10510.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationLineItems" xlink:to="us-gaap_NonoperatingIncomeExpense" order="10590.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationLineItems" xlink:to="us-gaap_IncomeTaxExpenseBenefit" order="10670.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationLineItems" xlink:to="us-gaap_NetIncomeLoss" order="10750.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/verboseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationLineItems" xlink:to="us-gaap_EarningsPerShareBasicAndDilutedAbstract" order="10830.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicAndDilutedAbstract" xlink:to="us-gaap_EarningsPerShareBasicAndDiluted" order="10990.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/positiveLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicAndDilutedAbstract" xlink:to="us-gaap_EarningsPerShareBasic" order="11070.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_EarningsPerShareBasicAndDilutedAbstract" xlink:to="us-gaap_EarningsPerShareDiluted" order="11150.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="akba_QuarterlyFinancialInformationLineItems" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingDilutedDisclosureItemsAbstract" order="11230.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_WeightedAverageNumberOfSharesOutstandingDilutedDisclosureItemsAbstract" xlink:to="us-gaap_WeightedAverageNumberOfShareOutstandingBasicAndDiluted" order="11390.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/positiveLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_WeightedAverageNumberOfSharesOutstandingDilutedDisclosureItemsAbstract" xlink:to="us-gaap_WeightedAverageNumberOfSharesOutstandingBasic" order="11470.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
    <presentationArc xlink:type="arc" xlink:arcrole="http://www.xbrl.org/2003/arcrole/parent-child" xlink:from="us-gaap_WeightedAverageNumberOfSharesOutstandingDilutedDisclosureItemsAbstract" xlink:to="us-gaap_WeightedAverageNumberOfDilutedSharesOutstanding" order="11550.00" priority="2" use="optional" preferredLabel="http://www.xbrl.org/2003/role/terseLabel" />
  </presentationLink>
</linkbase>




