The survival rate of patients received continuous renal-replacement therapy (RRT) treatment in our center has improved over past 10 years, and some changes have taken place during these periods.

Among them, early initiation of continuous renal-replacement therapy, lower fluid overload, and regional citrate anticoagulation method seems to be related to the improvement of outcome.

Ongoing evaluation of the practice changes and quality improvement of continuous renal-replacement therapy for critically ill pediatric patients still need attention.

A total of 289 patients were included in the study.

Of the two study periods, 2010–2014 and 2015–2019, the proportion of continuous renal-replacement therapy initiation time greater than 24 hours was significantly reduced, the percentage of fluid overload at continuous renal-replacement therapy initiation was lower, the percentage of regional citrate anticoagulation protocol was increased, and the ICU survival rate was significantly improved in the latter period compared with the former.

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