A 2022 review article discusses the use of continuous renal replacement therapy (CRRT) in critically ill children, highlighting the importance of understanding the mechanisms of clearance, factors influencing these processes, and appropriate selection of treatment candidates for CRRT. One key aspect associated with CRRT management is the use of regional citrate anticoagulation (RCA). RCA utilizes citrate to prevent coagulation by binding and chelating free ionized calcium in the extracorporeal circuit, which is essential for the formation of fibrin and clots in the coagulation cascade. Citrate is infused into the circuit after the blood leaves the patient but before it enters the CRRT filter, resulting in hypercoagulability within the circuit. Calcium is then infused back into the patient via a central line, independent of the circuit, to reverse anticoagulation and prevent hypocalcemia caused by citrate administration. However, the treatment protocol utilized for citrate-induced hypocalcemia prevention depends on the citrate solution used; generally, the citrate infusion rate is titrated to target a circuit ionized calcium concentration of 0.25-0.4 mmol/L. Additionally, calcium in a normal saline solution is infused concurrently to maintain the desired systemic ionized calcium concentration of 1.1-1.3 mmol/L. Of note, a specific calcium formulation and dose for the prevention of citrate toxicity is not provided within the review. [1]