Russell hurt knee ligaments and Hogg an ankle last Sunday while the Scots lost to Ireland 22-7 at Murrayfield.
Kinghorn will take the reins on Saturday at Murrayfield, having come off the bench in all four previous matches in this championship, while also scoring a try against Wales.
Smith's second and last Test was a start in the one-point loss to Australia in October, when Scotland could feature only local players.
Sam Skinner comes in for Richie Gray, who popped a rib against Ireland, while Hamish Watson is at openside flanker, pushing captain Jamie Ritchie to the blindside and Matt Fagerson to the reserves.
Munster flyhalf Ben Healy could make his debut off the bench. Healy, who qualifies for Scotland on his mother's side, is heading to Edinburgh next season.
Scotland have a chance to equal their best finish of third in the Six Nations era, and possibly reach second if France are surprised by Wales in Paris.
Italy will give a debut to Zebre wing Simone Gesi and, possibly off the bench, clubmate and hooker Marco Manfredi.
Among four changes after losing to Wales 29-17 in Rome, halfback Stephen Varney was dropped.
Alessandro Fusco will make his first Six Nations start after appearances off the bench in every match this year. His backup is Alessandro Garbisi, the brother of flyhalf Paolo, who hasn't appeared for Italy since July.
Edoardo Iachizzi has swapped with Niccolo Cannone into the second row, and Marco Riccioni was back at tigthhead prop.
Teams:
Scotland
Ollie Smith, Kyle Steyn, Huw Jones, Sione Tuipulotu, Duhan van der Merwe, Blair Kinghorn, Ben White; Jack Dempsey, Hamish Watson, Jamie Ritchie (capt), Jonny Gray, Sam Skinner, Zander Fagerson, George Turner, Pierre Schoeman.
Reserves: Ewan Ashman, Rory Sutherland, WP Nel, Scott Cummings, Matt Fagerson, Ali Price, Ben Healy, Cameron Redpath.
Italy
Tommaso Allan, Pierre Bruno, Juan Ignacio Brex, Tommaso Menoncello, Simone Gesi, Paolo Garbisi, Alessandro Fusco; Lorenzo Cannone, Michele Lamaro (capt), Sebastian Negri, Federico Ruzza, Edoardo Iachizzi, Marco Riccioni, Giacomo Nicotera, Danilo Fischetti.
Reserves: Marco Manfredi, Federico Zani, Pietro Ceccarelli, Niccolo Cannone, Giovanni Pettinelli, Manuel Zuliani, Alessandro Garbisi, Luca Morisi.