Meet the Expert 3 - AP AKI CRRT2026

Severe Hypernatremia and Hyperkalemia in AKI Requiring KRT

Yung-Ho Hsu Moderator

What will be covered:
This session focuses on the management of severe electrolyte disturbances in AKI patients requiring kidney replacement therapy, with emphasis on hypernatremia, hyperkalemia, and safe KRT prescription.

What participants will learn:
• How experts approach life-threatening electrolyte abnormalities in AKI.

• How to adjust KRT prescriptions safely.

• How to prevent overly rapid correction and treatment-related complications.

Take-home value:
Participants will gain practical strategies for managing severe dysnatremia and hyperkalemia in AKI patients receiving dialysis or CRRT.

Target audience:
Nephrologists, intensivists, ICU physicians, dialysis teams, fellows, and trainees.

教什麼:
本場次聚焦 AKI 且需要腎臟替代治療的病人，當出現嚴重電解質異常時的處置，特別是重度高血鈉、高血鉀，以及安全的透析或 CRRT 處方調整。

學什麼:
• 學習專家如何處理 AKI 病人危及生命的電解質異常。

• 掌握如何安全調整腎臟替代治療處方。

• 避免校正過快與治療相關併發症。

得什麼:
帶回 AKI 病人接受透析或 CRRT 時，處理嚴重血鈉異常與高血鉀的實用策略。

適合對象:
腎臟科醫師、重症醫師、加護病房醫師、透析團隊、臨床研究員與受訓醫師。

Time	Session

07:30 08:15	Severe Hypernatremia and Hyperkalemia in AKI Requiring KRT Ashita Tolwani Speaker The ABC of the CRRT prescriptionPrescribing continuous renal replacement therapy requires an understanding of how modality, blood flow, treatment dose, replacement-fluid delivery, and circuit factors influence therapy delivery. This presentation will provide a practical framework for developing and evaluating a CRRT prescription, including the principles of diffusive and convective clearance, prescribed versus delivered dose, and the impact of replacement-fluid location and treatment interruptions. Clinical examples will highlight common prescribing challenges and demonstrate how CRRT settings can be adjusted to meet changing patient needs while maintaining effective and safe therapy.AnticoagulationEffective anticoagulation is essential to maintain circuit patency, minimize blood loss, and ensure delivery of the prescribed CRRT dose. This presentation will review the principles guiding anticoagulant selection during CRRT, including the relative roles of regional citrate anticoagulation, unfractionated heparin, and alternative agents. Particular emphasis will be placed on balancing circuit longevity with patient safety, recognizing patients at increased risk for bleeding or citrate intolerance, and monitoring for metabolic and anticoagulation-related complications. Dysnatremia and acid-base disordersContinuous renal replacement therapy can be adapted to safely manage severe sodium and acid–base disturbances. This presentation will review a practical approach to modifying the CRRT prescription based on the patient’s serum sodium, acid–base status, and desired rate of correction. Emphasis will be placed on anticipating how CRRT solutions and treatment settings influence biochemical changes and on avoiding overly rapid correction or treatment-related complications. Clinical examples will illustrate key principles for individualized therapy.Severe hypernatremia and hyperkalemia in AKI requiring KRTManaging Patients With Combined Kidney and Liver Failure Manish Kaushik Speaker

Time

Session

07:30

08:15

Severe Hypernatremia and Hyperkalemia in AKI Requiring KRT

Ashita Tolwani Speaker The ABC of the CRRT prescriptionPrescribing continuous renal replacement therapy requires an understanding of how modality, blood flow, treatment dose, replacement-fluid delivery, and circuit factors influence therapy delivery. This presentation will provide a practical framework for developing and evaluating a CRRT prescription, including the principles of diffusive and convective clearance, prescribed versus delivered dose, and the impact of replacement-fluid location and treatment interruptions. Clinical examples will highlight common prescribing challenges and demonstrate how CRRT settings can be adjusted to meet changing patient needs while maintaining effective and safe therapy.AnticoagulationEffective anticoagulation is essential to maintain circuit patency, minimize blood loss, and ensure delivery of the prescribed CRRT dose. This presentation will review the principles guiding anticoagulant selection during CRRT, including the relative roles of regional citrate anticoagulation, unfractionated heparin, and alternative agents. Particular emphasis will be placed on balancing circuit longevity with patient safety, recognizing patients at increased risk for bleeding or citrate intolerance, and monitoring for metabolic and anticoagulation-related complications. Dysnatremia and acid-base disordersContinuous renal replacement therapy can be adapted to safely manage severe sodium and acid–base disturbances. This presentation will review a practical approach to modifying the CRRT prescription based on the patient’s serum sodium, acid–base status, and desired rate of correction. Emphasis will be placed on anticipating how CRRT solutions and treatment settings influence biochemical changes and on avoiding overly rapid correction or treatment-related complications. Clinical examples will illustrate key principles for individualized therapy.Severe hypernatremia and hyperkalemia in AKI requiring KRTManaging Patients With Combined Kidney and Liver Failure

Manish Kaushik Speaker