Abstract: Objective To evaluate the value of procalcitonin （PCT）, neutrophil-to-lymphocytes ratio （NLR）, neutrophil to lymphocyte and platelet ratio （N/LPR） in predicting acute kidney injury （AKI） in patients with severe acute pancreatitis （SAP）. Methods A total of 120 SAP patients were retrospectively collected. According to whether AKI occurred within 7-d hospital stay, all SAP patients were divided into the AKI and non-AKI groups. Clinical baseline data and laboratory parameters were compared between two groups. The predictive value of PCT, NLR and N/LPR for AKI in SAP patients was evaluated by the receiver operating characteristic （ROC） curve. Results In the AKI group, the C-reactive protein （CRP） level, PCT level, NLR, N/LPR and lactic acid level were significantly higher （all P < 0.05）, whereas the albumin level was significantly lower （P < 0.05） compared with those in the non-AKI group. Multivariate logistic regression analysis showed that PCT, NLR and N/LPR were the independent risk factors for SAP complicated with AKI （all P < 0.05）. ROC curve analysis demonstrated that the area under the ROC curve （AUC） of PCT, NLR, N/LPR, NLR+PCT, N/LPR+PCT, N/LPR+ NLR and N/LPR+ NLR+ PCT for predicting AKI were 0.750, 0.773, 0.882, 0.842, 0.884, 0.910 and 0.925, respectively. DeLong test indicated that the AUC of N/LPR for predicting AKI was significantly higher than that of NLR and PCT （both P < 0.05）, whereas no significant difference was observed between NLR and PCT （P > 0.05）.In addition, the AUC of different parameters combined for predicting AKI did not significantly differ from that of N/LPR alone （ all P > 0.05）. Subgroup analysis revealed that the incidence of AKI in SAP patients with PCT of ≥5.5 ng/mL was significantly higher than that in their counterparts with PCT of < 5.5 ng/mL. The incidence of AKI in SAP patients with NLR of ≥12.72 was significantly higher compared with that in their counterparts with NLR of <12.72. The incidence of AKI in SAP patients with N/LPR of≥11.11 was significantly higher than that in their counterparts with N/LPR of < 11.11 （all P < 0.05）. Conclusions Compared with NLR and PCT, N/LPR yields higher predictive value for AKI in SAP patients. It has not been found that the predictive value of different parameters combined for AKI is better than that of N/LPR alone.