Objective: Acute kidney injury (AKI) is a common and serious problem associated with poor prognosis. The aim of the study was to assess the prevalence and predictors of AKI in patients with non-ST elevation acute coronary syndrome (NSTE-ACS) with non-invasive strategy. Design and method: 288 patients (36% male, 72 ± 12 years (M ± SD), arterial hypertension 92%, previous myocardial infarction (MI) 42%, diabetes mellitus (DM) 23%, heart failure 36%, atrial fibrillation 23%, chronic kidney disease (CKD) 16%, baseline serum creatinine (SCr) 108 ± 55 mmol/l, GFRCKD-EPI 61 ± 23 ml/min/1.73 m2) were examined. Based on ESC Guidelines NSTE-ACS was qualified as NSTEMI or unstable angina (UA) in 186(64.5%)/102(35.5%) patients. AKI was diagnosed according to KDIGO 2012 Guidelines. Mann-Whitney test and multivariate logistic regression analysis were performed. P < 0.05 was considered statistically significant. ± Results: Incidence of AKI in NSTE-ACS was 36%: stage 1/2/3 – in 73/14/13% of cases. Patients with versus without AKI were older (75 ± 10 vs 70 ± 12 years, p < 0.001), had higher SCr (129 ± 73 vs 95 ± 29 mmol/l, p < 0.001), urea (11.1 ± 7.1 vs 7.8 ± 3.8 mmol/l, p < 0.001), plasma glucose at admission (9.0 ± 4.1 vs 7.8 ± 3.7 mmol/l, p < 0.001), higher rate of DM (31 vs 19%, p < 0.05), CKD (20 vs 11%, p < 0.05) anemia (35 vs 19%, p < 0.01), low left ventricular ejection fraction (EF) (44 ± 9 vs 48 ± 9%, p < 0.01), higher rate of acute heart failure (47 vs 24%, p < 0.01), MI (83 vs 55%, p < 0.001), recurrent MI (11 vs 2%, p < 0.001), in-hospital mortality (17 vs 5%, p < 0.01). Independent predictors of AKI were known CKD (odds ratio (OR) 3.9; 95% confidential interval (CI) 1.09–14.02, p < 0.05), GFRCKD-EPI < 59 ml/min/1.73 m2 (OR 3.9; CI 1.53–6.31, p < 0.001), urea >7.5 mmol/l (OR 3.8; CI 1.85–7.85, p < 0.001), MI (OR 3.6; CI 1.68–7.68, p < 0.001), EF < 35% (OR 2.6; CI 1.19–5.67, p < 0.01), plasma glucose >7 mmol/l at admission (OR 2.6; CI 1.28–5.35, p < 0.01), DM (OR 2.4; CI 1.02–5.73, p < 0.01). Conclusions: 36% of patients admitted to the hospital with NSTE-ACS developed AKI. AKI stage 1 was prevalent. Known CKD, GFRCKD-EPI <59 ml/min/1.73 m2, urea >7.5 mmol/l, MI, EF <35%, plasma glucose >7 mmol/l at admission, DM independently predicted AKI.