Abstract: OBJECTIVE To evaluate the anticoagulant effect and safety of low-dose argatroban and sodium citrate in continuous renal replacement therapy(CRRT) patients with high risk of bleeding. METHODS The 125 patients were prospectively divided into sodium citrate group(n=53) and argatroban group(n=72). CRRT filter life, coagulation function indexes, filter and pipeline clotting events, thrombosis events, bleeding events, CRRT parameters, and clinical indexes were compared between the two groups. RESULTS After treatment, the prothrombin time, international standardized ratio, and activated partial thromboplastin time of argatroban group were prolonged when compared with those of sodium citrate group(P<0.05). There were no significant difference in coagulation events between the two groups, but the proportion of non-coagulation in venous pot of sodium citrate group was higher than that of argatroban group(P<0.05), and the filter life was also longer(P<0.05). The incidence of total adverse reactions in the sodium citrate group was higher than that in the argatroban group(P=0.001). The blood flow and ultrafiltration rate in whom had filter clotting events were lower than those in whom had not filter clotting events(P<0.05). CONCLUSION Sodium citrate has a better anticoagulant effect in CRRT, however, argatroban has a better safety. The dose of argatroban should be increased in CRRT with low blood flow and low ultrafiltration rate.