**Study Overview**: This study tests the safety of a solution called Prismocitrate 18 used in a procedure called Continuous Renal Replacement Therapy (CRRT). CRRT is a kidney treatment for very sick patients. Prismocitrate 18 helps prevent blood clots during this treatment. The study uses a machine called the PrisMax System to make sure the treatment is safe and works well. **What to Expect**: - The study will last up to **10 days** for each patient. - You must be **18 years or older** and need CRRT to join. - You cannot join if you are allergic to citrate or have **certain liver issues**. **Eligibility**: You must be at least 18 years old, need CRRT, and have a consent form signed. You cannot take part if you are allergic to citrate, have specific liver problems, or are pregnant or breastfeeding. If you have any questions or concerns, please speak with your doctor to see if this study is right for you.