Khadzhynov D, et al. – This study investigated the role of initial lactate concentrations and lactate kinetics in predicting citrate accumulation during continuous veno–venous hemodialysis with regional citrate anticoagulation in critically ill patients. In well–selected patients, a low risk of citrate accumulation during regional citrate anticoagulation was reported even in case of initial severe hyperlactatemia. It was advocated that lactate kinetics rather than initially elevated lactate concentration should be considered in evaluating the risk of citrate accumulation.