The occurrence of acute kidney injuries in critically ill patients is 1-25% with a mortality of 15-60%. In two centres in Calgary, Alberta, South Health Campus (SHC) and Rockyview General Hospital (RGH), a patient population was identified in which conventional 72-hour continuous renal replacement therapy (CRRT) was not appropriate or ischemic hemodyalsis was unavailable. A collaborative nursing process identified this as an area for improvement based on a lack of IHD availability; challenges with ICU delirium surrounding day/night cycle and mobilization, and to negate a need for inter-facility transport of patients between sites for therapy. Based on these factors, a new “modified” renal replacement therapy was developed. The purpose of this presentation is to explain how this new dialysis therapy mode was developed including the use of accurate dosing, the challenges that were faced, the overall benefits and, finally, where we are at today with this new renal replacement therapy mode. The nursing teams from SHC and RGH worked in consultation with experts to develop a mode of CRRT that offered a 12-hour run with our current equipment. In addition, the physician groups at both sites assisted in the order set planning, making this truly an interdisciplinary approach to therapy development. Patient safety was of the utmost importance and inclusion criteria were developed on which patients would be most appropriate for this type of therapy. The initial group of patients receiving the therapy was approximately 25 to 30, with the goal for six unique patients. It should also be noted that this was the first instance that dosing was introduced into the Calgary region, and this new therapy highlighted the impact of achieving the proper dose for a patient. The results of the first initial runs were positive with some instances of patients' creatinine being halved after 12 hours of therapy. Since its inception, this modified run with dosing method has been requested both within Canada and abroad for use at various sites.