Chinese clinical practice guideline on prescription fluids application for continuous renal replacement therapy (2026 edition)

With the development of critical care techniques, continuous renal replacement therapy (CRRT) has become one of the most important life support methods. It is a key procedure to select and apply prescribed fluids for CRRT correctly, which is helpful to guarantee the performance and effect of CRRT and avoid some adverse complications. Critical Care Medicine Branch of China International Exchange and Promotion Association for Medical and Health Care and the Chinese Cooperation Group of Critical Care Blood Purification (CCG-CCBP) have developed this guideline to improve the CRRT level of related medical personnel, promote the standardization of CRRT, and improve the prognosis of those patients who receive CRRT. This guideline addresses five aspects: common types and components of CRRT prescription solutions, solute loss and replenishment in CRRT, clinical use of CRRT prescription solutions, adjustments to CRRT prescription solutions in special circumstances, and local citrate anticoagulation. It raises 17 clinical questions and uses the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) grading method to assess the quality of evidence and the strength of recommendations, ultimately resulting in 22 recommendations.

随着重症救治技术的不断发展，连续肾脏替代治疗（CRRT）成为重症患者的重要生命支持手段。正确地选择和应用处方液体是CRRT的关键环节，有助于保证血液净化治疗的正常进行和疗效，并规避一些不良并发症。为进一步提升相关医护人员的重症血液净化水平，推进CRRT的标准化和规范化，改善接受CRRT重症患者的预后，中国医疗保健国际交流促进会重症医学分会和中国重症血液净化协作组组织制订连续肾脏替代治疗处方液体应用临床实践指南。本指南针对CRRT处方液体的常见种类与成分、CRRT的溶质丢失与补充、CRRT处方液体的临床使用、特殊情况下的CRRT处方液体调整、局部枸橼酸盐抗凝5方面内容，提出17个临床问题，采用推荐意见分级的评估、制订与评价（GRADE）分级对证据质量和推荐意见强度进行分级，最终形成22条推荐意见。.