Sepsis is life-threatening organ dysfunction resulting from a dysregulated host response to infection. It is one of the commonest causes of acute kidney injury (AKI) and is associated with an increase in both morbidity and mortality. Both haemodynamic and non-haemodynamic factors are involved in the pathogenesis of AKI in sepsis. Newer tests are available for the early diagnosis of AKI in septic patients and may provide an opportunity for prevention. The current mainstay of prevention is adequate fluid resuscitation and maintenance of systemic blood pressure, noradrenaline being the vasopressor of choice. Renal replacement therapy may improve outcomes. Continuous renal replacement modalities are preferred in those who are haemodynamically unstable. There is no consensus on the optimal timing or dose of renal replacement therapy.