The study supports the clinical rationale for cilastatin, a well-established inhibitor of renal dipeptidase-1 (DPEP1), demonstrating a strong human safety profile and consistent protection against AKI across diverse patient populations.
Abstract
The analysis included data from over 6,800 patients across randomized and observational studies focused on high-risk clinical scenarios, including antibiotic-, chemotherapy-, and contrast-associated kidney injury.
Cilastatin treatment was associated a 74% lower risk of AKI in randomized controlled trials (3 trials, 245 patients), and a 46% lower risk in observational studies (4 studies, 6,321 patients). When pooled, the overall relative reduction in AKI risk was 48%.
Dr. James MD PhD (University of Calgary), who also leads the ongoing PONTiAK Phase IIb clinical trial of cilastatin in hospitalized patients, highlights that these findings support further clinical evaluation of cilastatin as a preventive therapy for drug-induced AKI.
Publication Details
Citation
Acharya, Dilaram et al. Nephroprotective Effects of Cilastatin in People at Risk of Acute Kidney Injury: A Systematic Review and Meta-analysis.
Kidney Medicine, Volume 6, Issue 12, 100913
Authors
Dilaram Acharya, Fanar Ghanim, Tyrone G. Harrison, Tayler Dawn Scory, Nusrat Shommu, Paul E. Ronksley, Meghan J. Elliott, David Collister, Neesh Pannu, Matthew T. James
“Cilastatin shows consistent nephroprotective effects in high-risk populations, supporting its potential clinical use to reduce the incidence and severity of AKI.”
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