Background: SARS-CoV-2 infects multiple critical organs such as the kidney, besides the lungs. Acute kidney injury caused after coronavirus disease requires immediate renal replacement therapy. In this case report, we present a new case of developing severe acute renal failure after testing positive for COVID-19. Case Description: This case was tested positive for COVID-19 twice. After the second testing, his renal function test increased drastically (serum creatinine, 9.68 mg/dl and urea 155mg/dl) along with deranged serum ferritin,823.6ng/ ml; CRP, 4.61mg/dl; leucocytes, 12 × 1000 cells/cubic mm; D-Dimer, 269ng/ml and was diagnosed with severe acute renal failure after corroboration with radiological investigations. He was aggressively treated with renal replacement therapy (5 cycles of hemodialysis) for renal injury along with other conservative management for COVID-19 disease. After 14 days of hospitalisation, he became clinically stable with normal renal function and was tested negative for COVID-19. He resumed all his normal activities immediately after hospitalisation, and resumed duty after 3 weeks of post-discharge. Clinical Relevance: Normal blood renal function test before the COVID-19 infection, sudden increase of blood values during the infection period, and reaching back to the normal range after treating the infection was highly suggestive of COVID-19 triggered severe acute renal failure. Regular monitoring of renal parameters along with other investigations is essential for managing the complications raised from COVID-19 infection. Health professionals need to be aware of kidney disease presentation during COVID-19 infection.

Keywords: AKI; RRT; Haemodialysis, Blood urea; Plasma creatinine, Before-during-after COVID-19