Continuous renal replacement therapy (CRRT) has been established as the standard treatment for acute kidney injury (AKI) in critically ill pediatric patients. CRRT transformed from an adapted therapy into the standard of care for pediatric critical care nephrology in the mid-1980s. The document provides guidance on managing electrolyte imbalances during CRRT such as increasing fluid flow rates for azotemia, adding saline for hyponatremia, and giving electrolyte-free water for hypernatremia.