Prevention of Nephrotoxin-Induced Acute Kidney Injury Using Cilastatin

Inclusion Criteria: * Age ≥ 18 years * Active treatment with an eligible nephrotoxic medication- IV vancomycin, IV aminoglycoside (gentamicin or tobramycin), IV calcineurin inhibitor (cyclosporine or tacrolimus), or IV or intraperitoneal platin-based chemotherapy or ifosfamide; or intraarterial radiographic contrast with two or more high-risk nephrotoxic medication exposures according to the NINJA algorithm. * Able to provide informed consent or have an authorized representative available and willing to give written informed consent after being properly informed of the nature and risks of the Study. Exclusion Criteria: * Stage 3 AKI based on Kidney Disease Improving Global Outcomes (KDIGO) SCr or urine output criteria, or receipt of short-term dialysis. * Category G5 CKD (defined as a CKD-EPI eGFR or \<15 mL/min/1.73 m2) or being treated with maintenance dialysis or a kidney transplant. * Pregnancy or lactation * Known hypersensitivity to imipenem-cilastatin. * Active or recent treatment (within 48 hours) with imipenem-cilastatin * Active or recent treatment (within 48 hours) with probenecid (medication used for gout prevention that inhibits cilastatin excretion and decreases plasma clearance) * Treatment with another investigational medicinal product or participation in another interventional Study within 30 days * Inability to comply with the requirements of the Study protocol.