Objective: To investigate the effect of acute kidney injury (AKI) on the success of noninvasive ventilation in chronic obstructive pulmonary disease (COPD) patients with hypercapnic respiratory failure Design: Retrospective observational cohort study Setting: Faculty of Meram Medicine, Necmettin Erbakan University, Konya, Turkey Subjects: This clinical study included 55 patients with decompensated COPD: 29 patients with AKI and 26 patients without AKI. Intervention: Demographical data, APACHE II scores, urea and creatinine values before non-invasive mechanical ventilation (NIMV) administration were recorded. Main outcome measures: The effect of AKI on the success of NIMV Results: There was no significant difference between sex, age and baseline respiratory rate of groups. There were statistically significant differences in baseline mean APACHE II score (21.4 +/- 5.3 vs 18.3 +/- 4.6, p=0.028), baseline mean pH (7.23 +/- 0.1 vs 7.30 +/- 0.1, p=0.001), urea (113.7 +/- 43.6 vs 45.2 +/- 13.0, p<0.001) and creatinine values (3.1 +/- 2.0 vs 0.9 +/- 0.3, p<0.001) of Group 1 and Group 2. Logistic regression analysis showed that none of these variable values tested have any effect on NIMV outcomes. Of the baseline variables tested, age (OR: 0.85; 95% CI: 0.69 to 1.07), sex (OR: 1.29; 95% CI: 0.89 to 1.89), baseline respiratory rate (OR: 1.02; 95% CI: 0.92 to 1.14), APACHE II score (OR: 1.03; 95% CI: 0.87 to 1.23), and AKI (OR: 0.79; 95% CI: 0.15 to 4.18) were not related to the outcome of NIMV in the logistic regression. Conclusions: We determined that AKI did not affect the outcome of NIMV in decompensated COPD patients.