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Recent evidence highlights the potential advantages of a low dialysis dose in limiting electrolyte disturbances, preserving essential nutrients, and reducing the need for pharmacologic interventions, while maintaining effective metabolic control. Regional citrate anticoagulation (RCA), widely considered as the first anticoagulation strategy for Continuous Kidney Replacement Therapy (CKRT), also contributes to dialysis buffer balance through the indirect generation of bicarbonate from citrate metabolism. In this regard, modulation of citrate metabolic load may allow the optimization of acid\u2013base balance without increasing dialysis intensity. Therefore, RCA may represent a versatile tool to individualize CKRT prescriptions, enabling both effective metabolic management and lower dialysis doses, thereby enhancing patient safety and therapeutic efficiency in the intensive care setting.<\/jats:p>","DOI":"10.1093\/joneph\/aajag009","type":"journal-article","created":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T12:53:57Z","timestamp":1767963237000},"page":"842-846","source":"Crossref","is-referenced-by-count":0,"title":["Tailoring dialysis prescription in a critically ill patient with AKI: the role of Regional Citrate Anticoagulation as a tool for acid-base optimization."],"prefix":"10.1093","volume":"39","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5496-4989","authenticated-orcid":false,"given":"Francesca","family":"Di Mario","sequence":"first","affiliation":[{"name":"UOS Dialisi, AOU Policlinico Umberto I , Rome 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