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Vasopressor and\u002For inotrope therapy for sepsis-induced hypotension (eg, norepinephrine \\[noradrenaline\\], epinephrine \\[adrenaline\\], phenylephrine, dopamine, dobutamine) for ≥ 4 hours.\n\nDiagnosis of AKI, within 72 hours of sepsis diagnosis, with modified KDIGO Stage ≥ 1, defined as: Increase in SCr to ≥ 1.5 × baseline (outpatient \\[preferred\\] or admission pre-AKI reference). Timing of AKI diagnosis is defined as the time that the initial qualifying SCr was reported. AKI must persist after completion of initial volume resuscitation (30 mL\u002Fkg or as clinically indicated per investigator discretion).\n\nOutpatient pre-AKI reference eGFR ≥ 30 mL\u002Fmin\u002F1.73 m2, if available within 2 weeks to 12 months prior to admission (preferred). If not available, admission pre-AKI reference eGFR ≥ 45 mL\u002Fmin\u002F1.73 m2 .\n\nBody weight ≥ 40 kg or ≤ 125 kg. Female or male, assigned at birth, inclusive of all gender identities. All FOCBP must have a negative pregnancy test at the Screening visit (Visit 1).\n\nContraception:\n\nA. Sexually active fertile male participants with partners of childbearing potential must adhere to the contraception methods detailed in CSP from the time of first administration of study intervention administration until 100 days after the last dose of study intervention.\n\nB. FOCBP must not be lactating and must agree to use an approved method of highly effective contraception, as detailed in the CSP from the time of first administration of study intervention until 100 days after last dose of study intervention.\n\nCapable of giving signed informed consent (participant or LAR). Provision of signed and dated written Optional Genomics Initiative Research Information and Consent Form prior to collection of samples for optional genomics initiative research.\n\nExclusion Criteria Any clinical evidence which in the investigator's opinion makes it undesirable for the potential participant to enrol in the study.\n\nKnown history of Stage 4 or 5 CKD with documented sustained eGFR \\\u003C 30 mL\u002Fmin\u002F1.73 m2 prior to hospital admission.\n\nSepsis diagnosed \\> 7 days after hospital admission (to include from time of outside admission if patient transferred from another healthcare setting).\n\nAKI attributed to causes other than sepsis, including but not limited to compromised renal perfusion-related causes (surgical complication, acute abdominal aortic aneurysm, dissection, renal artery stenosis, etc), glomerular disease, acute interstitial nephritis, and medication toxicity.\n\nEvidence of recovery from AKI prior to randomisation defined as:\n\nA. A reduction of SCr to less than 1.5 times reference SCr in the last available local SoC laboratory result before randomisation or B. A \\> 25% reduction in SCr from peak SCr after volume resuscitation prior to randomisation.\n\nExpected survival from sepsis \\\u003C 24 hours. Expected survival \\\u003C 90 days due to chronic or pre-existing medical conditions other than SA-AKI Known history of renal transplant or bilateral nephrectomy. Permanent incapacitation. Incapacitation is defined as the inability to independently perform tasks essential to personal health and\u002For safety.\n\nActive cancer or cancer in remission for less than 2 years. Known history of immunodeficiency disease or currently receiving immunosuppressant therapy for non-sepsis related disease.\n\nSevere burns requiring ICU treatment. Sepsis attributed to confirmed or presumed fungal or viral infection at time of Screening.\n\nHas advanced chronic liver disease, confirmed by a Child-Pugh score of 10-15 (Class C).\n\nKnown history of cerebrovascular accident within the last 90 days. Known history of heart failure with reduced ejection fraction with documented ejection fraction ≤ 20% before sepsis diagnosis.\n\nKnown hypersensitivity to iohexol or known history of severe adverse reaction to iodinated contrast media.\n\nParticipants with known medical or psychological condition(s), or who, in the judgement of the investigator, should not participate in the study if they are unlikely to comply with study procedures, restrictions, and requirements.\n\nCurrent KRT (eg, continuous haemofiltration and haemodialysis\u002Fcontinuous kidney replacement therapy, intermittent haemodialysis, and peritoneal dialysis) or planned KRT (meaning KRT is scheduled, or the decision to initiate KRT has been made by the treating physician) at randomisation.\n\nCurrently receiving active treatment for malignancy.\n\nPotential participants will be excluded if they have received a certain class of medication during the weeks before enrollment or are anticipated to require a specific class of medication during the trial duration.\n\nParticipants with a known hypersensitivity to AZD4144 or any of the excipients of the product.\n\nReceipt of another IMP within 30 days, 5 half-lives, or the time frame of expected PD effect from most recent dose, whichever is longest.\n\nPrevious receipt of AZD4144. Active or planned treatment of sepsis with an extracorporeal haemoperfusion device.\n\nParticipation in any other concurrent ICU study which could impact participant clinical outcomes and confound results of this study to, including but not limited to volume resuscitation, vasopressor, or mechanical ventilation studies.\n\nPresence of anuria (≥ 12 hours) at randomisation. Any clinically important abnormalities in rhythm, conduction, or morphology of the resting 12-lead ECG, at Screening, as judged by the investigator.\n\nProlonged QTcF \\> 470 ms. Known history of QT prolongation associated with other medications that required discontinuation of that medication.\n\nCongenital long QT syndrome. Known history of ST-elevation myocardial infarction or non-ST-elevation myocardial infarction, with or without intervention by percutaneous coronary intervention or coronary artery bypass grafting within the last 90 days.\n\nVentricular arrhythmia requiring treatment. Known or presumed latent or active tuberculosis. Acute pancreatitis with no established source of infection. Undergoing extracorporeal membrane oxygenation (ECMO) at randomisation. Neutropenia: ANC \\\u003C 1.5 × 109\u002FL. Admitting diagnosis of rhabdomyolysis. Admitting diagnosis of trauma with CK \\> 15000 U\u002FL. Presumed nidus of infection in central nervous system. Involvement in the planning and\u002For conduct of the study (applies to both AstraZeneca staff and\u002For staff at the study site).\n\nPrevious randomisation in the present study. For females only - currently pregnant (confirmed with positive pregnancy test) or breast-feeding.\n\nFirst infusion of IMP unable to be started within 36 hours of AKI diagnosis. Presence of a do-not-resuscitate order.","ALL","18 Years","80 Years",{"count":645,"type":646},124,"ESTIMATED","INTERVENTIONAL",[649],"PHASE2","This study will enroll adults aged 18 to 80 years diagnosed with sepsis due to a suspected or confirmed bacterial infection, within 7 days of being admitted to the hospital, and who have also developed acute kidney injury within 72 hours of the onset of sepsis. Eligible participants will be randomly assigned to receive either AZD4144 or a placebo intravenously once daily for the number of days specified in the CSP. During this Treatment Period, participants will undergo daily safety monitoring, as well as blood and urine sample collection and other assessments. After the Treatment Period, participants will continue to be monitored for safety and other assessments during each additional day they remain hospitalized (if applicable) as well as during up to 2 follow up visits after discharge. The main goal is to compare specific kidney function measurements between those participants receiving AZD4144 and those receiving the placebo.",[652,653],"Sepsis","Acute Kidney Injury",[652,653],"2026-06-19",{"date":657,"type":658},"2026-06-23","ACTUAL",{"date":660,"type":658},"2026-02-10",{"date":662,"type":646},"2027-02-11",{"name":5,"class":6},72]