延长的间歇性肾脏替代治疗(prolonged intermittent renal replacement therapy，PIRRT)是介于间歇性血液透析(intermittent hemodialysis，IHD)与连续性肾脏替代治疗(continuous renal replacement therapy，CRRT)之间的混合型肾脏替代治疗模式，通过延长单次治疗时间、降低血流量及透析液/置换液流速，在获得接近CRRT的血流动力学耐受性的同时保留间歇治疗的特征。为规范PIRRT的临床应用，中国医疗器械行业协会血液净化专业委员会、成都市医师协会肾脏内科专委会组织肾脏病学、重症医学、临床药学及儿科肾脏病学等多学科专家，基于系统文献检索、循证证据分级和多轮德尔菲专家咨询制定《延长的间歇性肾脏替代治疗临床应用专家共识》(以下简称“本共识”)。共识围绕PIRRT的术语与定义、适应证与禁忌证、设备与参数设置、血管通路、抗凝策略、抗菌药物剂量调整及并发症防治等关键临床问题形成推荐意见，并对血流动力学稳定性判定标准、超滤速率控制、维持性血液透析(maintenance hemodialysis，MHD)患者床旁PIRRT的应用、甲磺酸萘莫司他(nafamostat mesilate，NM)抗凝及抗菌药物监测参考范围等临床关切问题提出具体建议，旨在为各级医疗机构规范开展PIRRT提供系统、实用、循证的指导，提高治疗安全性与有效性，改善重症肾脏病患者预后。

Prolonged intermittent renal replacement therapy (PIRRT) is a hybrid kidney replacement modality positioned between intermittent hemodialysis (IHD) and continuous renal replacement therapy (CRRT). By extending the treatment duration of each session while lowering blood and dialysate/replacement fluid flow rates, PIRRT provides hemodynamic tolerability comparable to that of CRRT while preserving the intermittent nature of IHD. To standardize the clinical application of PIRRT in China, a multidisciplinary panel of experts in nephrology, critical care medicine, clinical pharmacy and pediatric nephrology developed this consensus based on a systematic literature review, evidence grading and multiple rounds of modified Delphi consultations. Recommendations cover terminology and definitions, indications and contraindications, equipment and parameter settings, vascular access, anticoagulation strategies, antimicrobial dose adjustment, and the prevention and management of complications. Specific guidance is provided on criteria for assessing hemodynamic stability, ultrafiltration rate control, the use of bedside PIRRT in maintenance hemodialysis (MHD) patients, nafamostat mesylate (NM) anticoagulation, and reference ranges for therapeutic drug monitoring of antimicrobials. This consensus aims to provide systematic, practical and evidence-based guidance for the standardized implementation of PIRRT in medical institutions at different levels, thereby improving treatment safety and effectiveness and ultimately improving outcomes in patients with severe kidney disease.