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In this study, we evaluated the diagnostic and prognostic value of the neutrophil gelatinase-associated lipocalin-2 (NGAL) level in urine as an early marker of renal dysfunction in preterm infants with very low and extremely low body weight. Aim - evaluation of diagnostic and prognostic significance of the urinary NGAL level as an early biomarker of acute kidney injury (AKI) in preterm infants. Materials and methods. The study included 104 premature babies, 78 of which formed the main group (AKI), and 26 babies - the comparison group (non-AKI). The main criterion for acute kidney injury in neonates according to neonatal classification AKIN (2011) is creatinine level > 1.5 mg/dL at the age of not earlier than 48 hours after birth. Results. The study identified a statistically significant correlation in the level of NGAL in the urine of children from the main and comparison groups. Conclusion. Biomarkers of kidney damage can give more accurate information than creatinine for the early diagnosis of AKI in children. In a comprehensive assessment of a child, it is necessary to take note of the indicators of renal function (creatinine, GFR) and biomarkers of injury (NGAL). This approach will allow performing the diagnostics and therapy of early AKI in children based on structural and functional criteria.