Regional citrate anticoagulation combined with nafamostat mesylate for continuous kidney replacement therapy in septic acute kidney injury patients: protocol for a prospective, three-arm, randomised controlled study (RCNM-CKRT)

Introduction: Extracorporeal circuit (EC) clotting remains a major challenge in continuous kidney replacement therapy (CKRT). While regional citrate anticoagulation (RCA) is recommended first-line, nafamostat mesylate (NM) offers an alternative with potential anti-inflammatory benefits. This trial aims to compare the effects of RCA, NM and their combination on EC lifespan during CKRT in critically ill acute kidney injury (AKI) patients with sepsis.