The SARS-CoV-2 virus has had a significant impact on a major part of the world, with kidneys being identified as a major target for infection. The incidence of acute kidney injury (AKI) associated with COVID-19 has been reported to range from 5% to 40% worldwide. Pre-existing renal dysfunction has been identified as a risk factor for adverse outcomes. This observational study aimed to analyze the impact of COVID-19 on kidneys in Indian patients hospitalized with various presentations of the disease. A total of 300 adult hospitalized patients with COVID-19 were included, and baseline clinical and laboratory data were analyzed. Follow-up was conducted after 3 months to assess the frequency and outcomes of renal dysfunction in patients with or without previous renal disease. The study found that the mean age of the patients was 37.15 \(\pm\) 9.78 years. The incidence of AKI was 12%, of which 80.6% of patients normalized their renal functions, while 8.30% progressed to chronic kidney disease (CKD). The mortality rate among these patients was 11.1%. Among the patients with pre-existing CKD, 66.6% experienced worsening renal function and 33.3% died. Additionally, 44.4% of these patients required hemodialysis. In conclusion, renal involvement was common among hospitalized COVID-19 patients, and outcomes were worse for patients with pre-existing CKD. The need for hemodialysis increased with disease severity and in patients with pre-existing CKD.