Prevention of Nephrotoxin-Induced Acute Kidney Injury Using Cilastatin

The goal of this clinical trial is to repurpose cilastatin for preventing acute kidney injury (AKI) in hospitalized patients receiving nephrotoxic medications. The trial will evaluate the efficacy of the re-purposed drug. The main questions it aims to answer are: \- whether cilastatin will prevent nephrotoxic AKI in hospitalized patients. Researchers will compare the drug cilastatin to a placebo (a look-alike substance that contains no drug) to see if drug cilastatin works to prevent AKI in hospitalized patients receiving nephrotoxic medications. Participants will: * Receive drug Cilastatin or a placebo intravenously every 6 hours for up to 24 hours after last exposure to nephrotoxic medication * Have blood test for kidney function every day they are on treatment. * Have a follow-up blood test at 90 days after randomization * Have a telephone survey at 90 days after randomization

NCT Number	NCT06886464
Lead Sponsor	Matthew James Collaborators: Alberta Health services, University of Alberta
Conditions	Acute Kidney Injury
Enrollment	698 participants
Start Date	2025-07-16
Primary Completion	2027-12-31 (estimated)
Study Completion	2029-12 (estimated)
Updated on ClinicalTrials.gov	2025-11-26