Objective: To compare the anticoagulation effect of local anticoagulation with citrate in the hemofiltration for sepsis patients with acute renal injury and observe the safety of anticoagulation to provide the basis for clinical anticoagulation of hemofiltration.Methods: Totally 72 patients with sepsis acute kidney injury in the hospital were randomly divided into the control group and the study group with 36 ones in each according to the single and double number.The control group and the study group was respectively treated with heparin sodium and citric acid for anticoagulation with the treatment course of 7 days.The life of filter tube and filter of the two groups were recorded, and the coagulation grade of filter was assessed.The levels of serum creatinine (Scr), blood urea nitrogen (BUN), pH, serum sodium bicarbonate and bicarbonate were measured before and after the treatment.The activated coagulation time (ACT) was measured before the filtration and in 8 h and 24 h after the filtration.The adverse reactions were observed as well.Results: The ratio of blood clotting level at 0-1 grade in the study group was higher than that in the control group, and the ratio of filter coagulation at 2-3 grade in the study group was lower than that in the control group, and the differences were statistically significant (P<0.05).The life of filter pipe and filter in the study group was longer than that in the control group, and the difference was statistically significant (P<0.05).ACTs in 8 h and 24 h after the blood filtration in the study group were longer than those in the control group, and the difference was statistically significant (P<0.05).The levels of BUN and Scr of the two groups after the treatment were lower than those before the treatment, and the differences were statistically significant (P<0.05).There were no significant differences in blood pH, HCO3-, Na + and adverse reactions before and after the treatment between the groups (P>0.05).Conclusion: The application of hemofiltration in the treatment of sepsis patients with acute renal injury can significantly improve renal function.And local anticoagulation has better anticoagulant effect in septic acute renal injury patients with hemofiltration, which can prolong the life of filter tube and filter with higher security.