Objective  To investigate the diagnostic value of peripheral blood coagulation parameters and procalcitonin (PCT) levels in sepsis‑associated acute kidney injury (AKI). Methods  Medical records of 131 septic patients admitted to Jieshou People’s Hospital from September 2021 to February 2025 were retrospectively selected. Patients were divided into an observation group (sepsis with AKI, n=55) and a control group (sepsis without AKI, n = 76). Coagulation parameters and PCT levels were compared between the two groups, and their diagnostic value for sepsis‑associated AKI was analyzed. Results  The observation group had significantly higher levels of activated partial thromboplastin time (APTT), fibrinogen (FIB), thrombin time (TT), D‑dimer, PCT, serum creatinine (Scr), blood urea nitrogen (BUN), and cystatin C (Cys C) than the control group (t=4.909, 6.139, 7.488, 6.629, 8.685, 2.797, 4.987, 4.333; all P＜0.001). Logistic regression analysis showed that elevated levels of APTT (OR=1.483, 95% CI: 1.293～1.700, P＜0.001), FIB (OR=11.761, 95% CI: 4.902～28.217, P＜0.001), TT (OR=5.755, 95% CI: 2.952～11.219, P＜0.001), D‑dimer (OR=13.573, 95% CI: 5.192～35.482, P＜0.001), PCT (OR=3.196, 95% CI: 1.946～5.249, P=0.036), Scr (OR=1.073, 95% CI: 1.045～1.101, P＜0.001), BUN (OR=1.030, 95% CI: 0.925～1.148, P＜0.001), and Cys C (OR=4.301, 95% CI: 2.546～7.268, P＜0.001) were independent risk factors for AKI in septic patients. The area under the curve (AUC) of the combined diagnosis using APTT, FIB, TT, D‑dimer, and PCT for sepsis‑associated AKI was 0.903(ZAPTT vs. combined=3.215, P=0.001; ZFIB vs. combined =3.458, P=0.001; ZTT vs combined=2.437, P=0.015; ZD-dimer vs. combined=3.681, P＜0.001; ZPCT vs. combined=2.519, P=0.012).  Conclusion  Elevated coagulation parameters, PCT, and renal function indices are independent risk factors for sepsis-associated AKI. The combination of coagulation parameters and PCT demonstrates good diagnostic performance.