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During the congress, E-Posters will be accessible to all participants on the congress website 24/7, as well as in the E-poster stations in the congress center.
Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
Cilastatin is an inhibitor of drug metabolism and uptake in the proximal tubule. In vivo studies demonstrate a renoprotective effect of cilastatin in AKI models but to date, cilastatin is only available in combination with imipenem, a carbapenem antibiotic, cilastatin/imipenem (CI). Although studies suggest that CI may reduce the risk of AKI relative to other carbapenems, the effect of CI in patients in intensive care unit (ICU) with high risk of AKI has not been assessed. We assessed this issue using Medical Information Mart for Intensive Care III (MIMIC-3) database.
We conducted a retrospective cohort study using the MIMIC-3 database. Subjects in MIMIC-3 treated with CI (CI group) or non-cilastatin carbapenems (NCC group) during ICU stay were included. Propensity score matching (PSM) was performed to adjust baseline of the subjects between the groups. The primary outcome was development or progression of AKI, assessed by Kidney Disease Improving Global Outcomes (KDIGO) criteria, within 7 days after the first carbapenem treatment. The rate of increase of serum creatinine (sCr) within 7 days and renal death (defined as newly initiation of dialysis) in ICU stay were also assessed. Subjects with AKI stage 3 (which includes receiving dialysis) at the time of treatment were excluded from PSM for the primary outcome, and subjects already receiving dialysis prior to treatment were excluded from PSM for other outcomes.
1298 subjects (87 subjects in CI group and 1211 subjects in NCC group) were included. Mean (and standard deviation, SD) age was 64.2±15.6 years, 56.8% were male. Median (and interquartile range, IQR) AKI stage at the time of treatment was 0.00 [0.00, 1.00] in CI group and 1.00 [0.00, 2.00] in NCC group (p<0.001). For the primary outcome, 77 matched subjects in each group were assessed. Development or progression of AKI stage was observed in 14 subjects (18%) in CI group and 25 subjects (32%) in NCC group (odds ratio and 95% confidential interval [CI] of IMI group: 0.46 [0.21-0.97], p=0.04). For the secondary outcomes, 86 matched subjects in each group were assessed. Development of renal death in ICU (4.7% and 8.1%, odds ratio [95%CI]: 0.55 [0.14-1.90], p=0.35) and increase rate of sCr (median [IQR]: 1.20 [1.00, 1.43] and 1.29 [1.02, 1.56], p=0.75) were similar between the groups. Among those with AKI at the time of treatment, CI group showed reduced rate of sCr increase relative to the NCC group (1.39 [1.03, 1.60] and 1.50 [1.25, 3.00], p=0.04).
CI associates with less AKI development or progression among patients in ICU relative to other carbapenems. Cilastatin potentially reduces the risk of AKI among patients in ICU.
