This study aimed to evaluate the risk of AKI in patients treated with non-vitamin K antagonist oral anticoagulants (NOACs). We conducted a retrospective cohort study using the hospital electronic health record (EHR)-based Common Data Model (CDM) database from 14 tertiary hospitals in Korea. The study cohort included patients aged 18 and older, diagnosed with conditions including atrial fibrillation, deep vein thrombosis, pulmonary embolism, myocardial infarction, cerebral infarction between January 2016 and June 2022. We compared individuals who initiated NOACs with those who never received the oral anticoagulants. The primary outcomes were AKI and increased serum creatinine levels. To adjust for measured confounders, we implemented 1:1 propensity score (PS) matching and used a Cox proportional hazards regression model to estimate hazard ratios (HRs) with 95% confidence intervals (CIs). Additionally, we conducted subgroup analyses based on sex, age, specific NOAC ingredient, and chronic disease status. A total of 375,205 patients were included in the cohort. After matching based on PS, 63,667 patients were selected for both the NOAC users and the NOAC non-users. The NOAC users had a significantly higher risk of AKI compared to the NOAC non-users (adjusted HR = 1.41; 95% CI = 1.27–1.57). Subgroup analyses revealed AKI risk variations among NOAC users based on the aforementioned factors.