In December 2019, a coronavirus outbreak began in Wuhan, China, and spread globally. This study investigated the prevalence of acute kidney injury (AKI) and its association with in-hospital death in patients with COVID-19. A prospective cohort study of 701 patients admitted to a tertiary hospital in Wuhan found that 16.1% died in hospital, with 5.1% developing AKI. Patients with elevated baseline serum creatinine, elevated blood urea nitrogen, AKI stages 1-3, proteinuria, and hematuria were independent risk factors for in-hospital death. Kidney disease was associated with higher mortality, highlighting the importance of monitoring kidney function in patients with severe COVID-19. The study suggests that early detection and intervention for kidney involvement may improve outcomes. The findings indicate that kidney disease is a significant complication of COVID-19 and a major risk factor for death. The study was conducted in a single center, so generalizability is limited. However, the results emphasize the need for increased awareness of kidney disease in patients with severe COVID-19. The study also highlights the importance of frequent serum creatinine measurements for early detection of AKI in patients with COVID-19. The etiology of kidney disease in patients with COVID-19 is likely multifactorial, including direct viral effects on kidney tissue, immune-mediated damage, and indirect effects from cytokines and mediators. The study underscores the need for further research to understand the long-term effects of COVID-19 on kidney structure and function. The study was conducted in a tertiary hospital in Wuhan, with limitations including the lack of accurate baseline serum creatinine data and potential confounding factors. The study provides important insights into the association between kidney disease and mortality in patients with COVID-19, emphasizing the need for early detection and intervention.In December 2019, a coronavirus outbreak began in Wuhan, China, and spread globally. This study investigated the prevalence of acute kidney injury (AKI) and its association with in-hospital death in patients with COVID-19. A prospective cohort study of 701 patients admitted to a tertiary hospital in Wuhan found that 16.1% died in hospital, with 5.1% developing AKI. Patients with elevated baseline serum creatinine, elevated blood urea nitrogen, AKI stages 1-3, proteinuria, and hematuria were independent risk factors for in-hospital death. Kidney disease was associated with higher mortality, highlighting the importance of monitoring kidney function in patients with severe COVID-19. The study suggests that early detection and intervention for kidney involvement may improve outcomes. The findings indicate that kidney disease is a significant complication of COVID-19 and a major risk factor for death. The study was conducted in a single center, so generalizability is limited. However, the results emphasize the need for increased awareness of kidney disease in patients with severe COVID-19. The study also highlights the importance of frequent serum creatinine measurements for early detection of AKI in patients with COVID-19. The etiology of kidney disease in patients with COVID-19 is likely multifactorial, including direct viral effects on kidney tissue, immune-mediated damage, and indirect effects from cytokines and mediators. The study underscores the need for further research to understand the long-term effects of COVID-19 on kidney structure and function. The study was conducted in a tertiary hospital in Wuhan, with limitations including the lack of accurate baseline serum creatinine data and potential confounding factors. The study provides important insights into the association between kidney disease and mortality in patients with COVID-19, emphasizing the need for early detection and intervention.