Objective To investigate the clinical effect of low-molecular-weight heparin (LMWH) for hemodialysis-hemoperfusion combined therapy. Methods Twenty-five end-stage renal disease patients (14 males and 11 females; mean age: 62.3 years) subjected to hemodialysis-hemoperfusion combined therapy were included. The dose of LMWH was adjusted based on dry body weight. Patients with dry weight <40kg were intravenously given a single bolus of Fraxiparine 0.4ml at the beginning of the treatment, those with dry body weight 40-60kg were intravenously administrated a bolus of Fraxiparine 0.4ml followed by an additional injection of 8mg heparin one hour after the treatment, and those with dry body weight >60kg were intravenously given a bolus of Fraxiparine 0.4ml followed by an additional injection of 12mg heparin one hour after the treatment. Results A total of 352 sessions of hemodialysis-hemoperfusion combined therapy were conducted. The incidence of thrombus in resin hemoperfusion cartridge was 0.28%, and in dialyser was 3.69%. Patients with arteriovenous fistula were treated with the combined therapy for 260 sessions, and those with central venous catheter for 92 sessions; their incidence of thrombus in dialyser was 3.08% and 5.43%, respectively. Hemostasis time was 11.3±5.21 minutes, and no treatment-induced bleeding was found. Conclusions We used dry body weight to optimize the LMWH dosage for hemodialysis-hemoperfusion combined therapy and achieved a better clinical effect, thus providing an alternative anticoagulant approach for hemodialysis-hemoperfusion combined therapy.