Objective To investigate the application of regional citrate anticoagulation to hemodialysis (HD), continuous venovenous hemofiltration (CVVH) and hemodiafiltration (HDF) in order to find a safe effective and simple regional anticoagulation method. Methods Fifty-six patients were divided into 2 groups: 46 patients in regional citrate anticoagulation (RCA) group were treated with 86 blood purification sessions, and 39 sessions for 10 patients in control group using without or low-dose heparinization. The Activated coagulation time (ACTs) and the efficiency of extracorporeal coagulation were observed. The serum ionized calcium, citrate, bicarbonate, sodium, serum creatinine and urea concentration. were monitored. Results RCA group: the ACTs of the extracorporeal circuit remained approximately 39%～75%（P<0.01）above the baseline ACT, and the ACTs of the systemic blood remained in the pretreatment range. Dialyzer clotting occurred less than in control group. And clotting in venous drip chamber occurred also less than in control group (except in hemodiafiltration). The serum ionized calcium concentration remained in normal range. The citrate level was in safe range. Hypernatremia and metabolic alkalosis did not occur. The clearance of serum creatinine and urea was ideal. Conclusion The application of regional citrate anticoagulation to various forms of blood purification was shown to be effective, and systemic anticoagulation did not occur. Complications were not found. The effect of this treatment was ideal. Using regional citrate anticoagulation during HD, HDF and CVVH was simple, safe and effective for patients with increased risk of bleeding.