Objective To explore the influencing factors of renal injury in elderly patients with cor pulmonale, and to provide information for the prevention of renal injury in patients with cor pulmonale. Methods A total of 309 elderly patients with cor pulmonale over 60 years old treated in our hospital from June 2019 to December 2020 were included in the study. According to the patients with renal injury , they were divided into cor pulmonale renal injury group (case group) and cor pulmonale non renal injury group (control group). The basic information of the two groups and the influencing factors of potential renal injury in the past were collected, The influencing factors of renal injury in elderly patients with cor pulmonale were analyzed by univariate analysis and regression model. Results The single factor analysis of the case group was higher than that of the control group, with a male age of 80 years, smoking history, family history of diabetes, concurrent infection, diabetes mellitus and left ventricular ejection fraction (LVEF) <56.00% ratio. The difference between the case group and the control group was higher than that of the control group (P<0.05). The above univariate analysis results were brought into the multiple regression model. The final multiple regression analysis showed that age > 80 years old (or = 3.142), smoking history (or=2.115) , concurrent infection (or=4.263) , and excessive systolic blood pressure (or=2.279) were the risk factors potentially increasing the risk of renal injury, which were statistically significant (P < 0.05). Conclusion Elderly patients with cor pulmonale over 80 years old , with smoking history and abnormal blood pressure , as well as those complicated with infection , have an increased risk of renal injury. It is worthy of clinical attention and relevant preventive measures to improve the prognosis of patients.