This study is researching how well a new treatment, R2R01 combined with terlipressin, works compared to terlipressin alone for people with a condition called Hepatorenal Syndrome (HRS) - Acute Kidney Injury (AKI). HRS-AKI is a serious kidney problem that happens in people with liver disease. Terlipressin is a medicine given through a vein to help with this condition. R2R01 is a new treatment being tested. The study will last about 15 weeks for each person and includes a treatment period of up to 14 days, followed by about 76 days of check-ups.

This study will be done at about 25 places in Europe, the UK, the US, and Canada. Participants must be at least 18 years old, have certain liver and kidney conditions, and be willing to follow all study instructions. Some people cannot join the study, like those with very severe kidney problems or other serious health issues.

• Participants will visit the study site multiple times over 15 weeks.
• The study is looking for how safe and effective the combination of R2R01 and terlipressin is.
• Participants will receive compensation for their time and travel.