This study aimed to analyze the factors related to acute kidney injury (AKI) in patients with heatstroke (HS). Patients with HS who visited the hospital from January 2013 to December 2019 were retrospectively analyzed. These patients were divided into an AKI and a non-AKI group based on the presence of AKI. Patients in the AKI group were further divided into the transient and persistent AKI groups. The differences in clinical characteristics between the AKI and the non-AKI group and the persistent AKI group and transient AM group were analyzed to study the related factors of the occurrence of AM. Male patients were more prone to AM (P= 0.01). Compared with the non-AKI group, HS patients with AKI had a higher core body temperature (CBT) (P < 0.001) and lower mean arterial pressure (MAP) (P= 0.004). In addition, the incidence of mechanical ventilation, renal replacement therapy (RRT), and blood transfusion were higher in the AM group (P < 0.001). However, the proportion of patients among whom cooling the CBT to 38.9 degrees C within 30 min had taken place was lower (P = 0.007), and the risk of Disseminated Intravascular Coagulation (DIC) and death was higher (P < 0.001). There was no statistical difference in age, basic disease, heat index, and other indexes (P > 0.05). Compared with the transient AKI group, patients with persistent AKI had higher serum creatinine (Scr) levels, WBC counts, a higher rate of transfusion, DIC and death (P < 0.05), and a lower rate of cooling the CBT to 38.9 degrees C within 30 min from the discovery of unconsciousness (P= 0.006). There were no significant differences between the two groups in terms of gender, age, highest CBT and MAP at admission, RRT, mechanical ventilation, or other factors (P > 0.05). Multivariate logistic regression analysis showed that the highest CBT (OR2.54; 1.007-6.42) and the Scr level on admission (OR 1.13; 1.07-1.18) were risk factors for AKI in HS patients (P < 0.05). The highest CBT and Scr levels on admission are independent risk factors for AKI, while the duration and progression of AKI may be associated with delayed CBT cooling.