Abstract: Objective: To  construct  a  precise  natriuretic  adjustment  mini⁃program  with  replacement  fluid  and evaluate its efficacy and safety in continuous renal replacement therapy(CRRT)  combined with sodium citrate anticoagulant therapy in patients with hypernatremia.    Methodology:A total of 36 patients with hypernatremia from January 2021 to June 2024 were  randomly  divided  into  trial  and  error  group  and  precision  sodium  regulation  group,  both  of  which  received conventional treatment plus  CRRT  and  sodium  citrate  anticoagulation.  The  trial⁃and⁃error  group  adjusted  the  replacement fluid based on physician experience, while  the  precision sodium regulation group  utilized  a  mini⁃program  to  automatically calculate the composition of  the  replacement  fluid.  Compare  the  heart  rate,  mean  arterial  pressure,  peripheral  blood  free calcium ions, pH value, HCO- , BE, serum chloride  levels, clinical  efficacy  at 14 days  post⁃treatment, sodium⁃lowering effect, and  the  work  efficiency  and  satisfaction  of  medical  staff  between  the  two  groups  before  and  after  treatment. Results:After 8 h of  treatment,  the  heart  rate  and  mean  arterial  pressure  in  the  precision  sodium  regulation  group  were significantly  decreased  (P < 0.05 ),  outperforming  the  trial⁃and⁃error  group.  There  were  no  significant  differences  in peripheral blood free  calcium  concentration,  serum  chloride  ion  and  14⁃day  curative  effect  between  the  two  groups  (P > 0.05). After treatment, the pH value, HCO- , BE and serum sodium ion were all improved (P<0.05), but there was no significant difference between the two groups. There were statistically significant differences in sodium reduction at 2 h, 4 h and 8 h between and within the two groups (P< 0.001), but  no  interaction  (P> 0.05).  The  precision  sodium  regulation group was superior  to  the  trial⁃and⁃error  group  in  the  time  to  achieve  accurate  and  stable  sodium  reduction,  8h  average speed of  sodium  reduction,  calculation  time  of  replacement  solution  and  satisfaction  of  medical  staff  (P < 0.001 ). Conclusion:The use of a precision sodium adjustment mini⁃program for  replacement  fluid in CRRT combined with citrate anticoagulation for the treatment of hypernatremia patients is safe and effective, enhancing work efficiency.

Key words:  hypernatremia    , precise  sodium , adjustment , in  replacement , fluid    , citrate  anticoagulation    , continuous renal replacement therapy