Background: In preterm newborns, acute kidney damage (AKI) often develops. Administration of caffeine may prevent acute renal damage in extremely low neonates of birth weight. The objective of this research was to determine if administering caffeine citrate to premature infants will alter the occurrences of AKI. Methods: This case-control research was conducted on preterm neonates hospitalised to Benha University and Algalaa Teaching Hospital in neonatal critical care centres. All neonates were divided into two groups: Group I: included (50) premature newborns receiving citrate of caffeine. Group II: comprised (50) non-caffeine citrate preterm newborns. The definition of the modified newborn kidney disease (KDIGO) has been utilised for the evaluation of acute kidney injury stage. Result: 45 percent of all preliminary newborns admitted to our neonatal intensive care unit (NICU) had AKI in this research. The AKI rate among exposed groups of caffeine was 38 percent, statistically significantly lower than AKI among exposed groups of non-caffeine (52 percent). Wert P = 0.015. Statistically significantly shorter gestational age and birth weight were in Group I than Group II There was no statistically significant difference in delivery method, sex, apgar scores for 1 and 5 minutes between group I and group II. Conclusions: Caffeine is linked with decreased risk of acute renal damage in preterm babies.