Do you recommend any CRRT prescription changes for optimal clearance for patients with AKI who are on a reduced blood flow rate due to concurrent regional citrate anticoagulation?

In distinction to conventional HD, solute clearance in CRRT is limited by dialysate/replacement solution flow, not blood flow. So, no, I do not make changes in the CRRT just because of a decrease in blood flow rate.

At our hospital we only do CVVH, so blood flow rate does not affect clearance. If we were doing CVVHD, I would base my decision of how much clearance to provide on serum electrolytes and serum phosphorus concentration. In case of hyperkalemia, there are 2 options, increase dose of dialysis or lower ...