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Background: Decreased renal blood flow plays a vital role in the etiology of acute kidney injury (AKI). In this study, we aim to investigate the role of renal regional oxygen saturation (rSO 2 ) reductions in predicting AKI in the first 24 h of life., Methods: One hundred premature babies with a gestational age of ≤32 weeks were included. Renal and cerebral rSO 2 s were monitored for 24 h by near-infrared spectroscopy. Infants were followed up for the first 7 days for the diagnosis of AKI., Results: Infants' median gestational age was 29 (23-32) weeks, and their birthweight was 1,192 ± 355 g. It was found that the renal rSO 2 values were lower in the first 24 h of life in patients who developed AKI, and this decrease was statistically significant in the first 6 h of life., Conclusions: The low renal rSO 2 values in the early hours of life in premature babies may have a role in predicting AKI., (© 2020 Japan Pediatric Society.)