[New perspectives on anticoagulation for continuous renal replacement therapy: application status and optimization of regional citrate anticoagulation protocol].

At present, the national guidelines recommend regional citrate anticoagulation as the first-line strategy for continuous renal replacement therapy (CRRT) in patients without contraindications, owing to its stable and controllable anticoagulation effect, low bleeding risk, favorable biocompatibility, and relatively few contraindications. However, this strategy still presents clinical drawbacks, including inadequate anticoagulation, higher bleeding risk, and increased medical costs. Based on the clinical practice experience of citrate anticoagulation in CRRT and the existing research evidence, this paper reviews the current application status and core requirements of the regional citrate anticoagulation protocol, summarizes the problems encountered in the implementation of current anticoagulation treatment protocols, and proposes optimization measures. It also explores alternative anticoagulation strategies for special populations and combined anticoagulation regimens, with the aim of providing new insights for improving the safety and cost-effectiveness of CRRT.