Mark Doyle, who impressed as a second half replacement against France, comes into the team and is named on the right wing instead of Kearney.
There has also been a reshuffle in the front row, with Jack McGrath swapping sides from loosehead to tighthead.
Paddy McAllister comes off the replacements bench to start at loosehead and Jack O'Connell moves into the replacements.
Ronan O'Mahony has been added to the bench as a result of Mark Doyle's promotion. Also joining the matchday squad is scrum half Matthew Healy who has take John Cooney's place.
Ireland coach Allen Clarke said: "The game against France showed the character of the squad, the work rate and defensive efforts were significant and the determination to force the vital, late score was very pleasing.
"Saturday's game against Italy poses a further challenge. Italy asked significant questions of England in defeat and will no doubt be looking to kickstart their campaign at home.
"Our focus is to build on the positives from last week and improve the accuracy of our decision-making and execution in attack.
"We have made some changes to the starting team. Andrew Burke was not considered for selection due to injury and the back-line has been reshuffled with Ian Madigan moving from full-back to out-half, (David) Kearney from wing to full-back and Mark Doyle to the wing with Ronan O'Mahony taking the available spot on the bench.
"The change in the forwards sees (Paddy) McAllister coming in at loosehead with Jack McGrath moving across to tighthead and Jack O'Connell now on the bench."
* There will be be live web only coverage (island of Ireland) on www.rte.ie of the Ireland Under-20s' clash with their Italian counterparts on Saturday afternoon, starting from 1.58pm Irish time. Hugh Cahill and former Ireland international David Corkery will provide commentary.
IRELAND UNDER-20 TEAM & REPLACEMENTS (v Italy Under-20s, Beltrametti Stadium, Piacenza, Saturday, February 14, kick-off 3pm local time/2pm Irish time):
15 - David Kearney (Lansdowne/Leinster)
14 - Mark Doyle (UL Bohemians/Munster)
13 - Ian McKinley (UCD/Leinster)
12 - Eamonn Sheridan (Lansdowne/Leinster)
11 - Michael Keating (Clontarf/Leinster)
10 - Ian Madigan (Blackrock College/Leinster)
1 - Paddy McAllister (Ballynahinch/Ulster)
2 - Thomas Sexton (Old Belvedere/Leinster)
3 - Jack McGrath (St. Mary's College/Leinster)
4 - Ciaran Ruddock (Neath/Exiles)
5 - Mark Flanagan (UCD/Leinster)
6 - Rhys Ruddock (Millfield School/Exiles)
7 - Dominic Ryan (Lansdowne/Leinster)
8 - Peter O'Mahony (Cork Constitution/Munster) (capt)
16 - David McGregor (Ballynahinch/Ulster)
17 - Jack O'Connell (Lansdowne/Leinster)
18 - James Sandford (Queens University/Ulster)
19 - Michael Noone (Seapoint/Leinster)
20 - Matthew Healy (Lansdowne/Leinster)
21 - Gary Foley (Blackrock College/Leinster)
22 - Ronan O'Mahony (Garryowen/Munster)