Inclusion Criteria:

• Aged ≥18 and ≤75 years, without restriction on gender.
• Patients with a definite clinical diagnosis scheduled for elective cardiac and macrovascular surgery with cardiopulmonary bypass (CPB) support, including but not limited to coronary artery bypass grafting (CABG), cardiac valve replacement/repair, structural heart disease surgery, aortic arch plasty, or combined procedures of the above surgeries.
• Classified as high risk by AKI risk scoring system, with a total score ≥4 points.
• The subject or their legal representative shall fully understand the purpose, procedures, potential risks and benefits of this study, and voluntarily sign the written informed consent form.

Exclusion Criteria:

• Patients with severe chronic renal insufficiency (eGFR < 50 mL/min/1.73 m² or serum creatinine > 300 μmol/L), or those receiving any form of renal replacement therapy (e.g., hemodialysis, peritoneal dialysis).
• Pre-existing acute kidney injury.
• Presence of chronic or active liver diseases, including decompensated liver cirrhosis, active viral hepatitis, autoimmune liver disease, etc.; or preoperative laboratory tests showing ALT/AST ≥ 2 times the upper limit of normal (ULN).
• Severe hematological diseases (preoperative white blood cell count < 3.0 × 10⁹/L, platelet count < 80 × 10⁹/L).
• Uncontrolled active infections, or known immunodeficiency disorders (e.g., HIV infection, status post organ transplantation).
• History of severe hypersensitivity to terbinafine or any excipients of its formulation.
• Pregnant or lactating women, as well as women of childbearing potential who plan to conceive during the study and refuse to use effective contraception.
• Participation in any other clinical trial of investigational drugs or medical devices within 3 months prior to screening.
• Patients deemed inappropriate for enrollment in this study at the investigator's clinical discretion.