Abstract: An improved hemodialysis method (which may optionally include a hemoperfusion step) including regional extracorporeal citrate anticoagulation is disclosed which permits complete elimination of conventional heparin treatment and possible consequent medical complications from heparin use. The method preferably comprises removing blood from a patient at a level of at least about 80 milliliters per minute, infusing citrate anticoagulant into the blood at a level of up to about 10 millimoles of citrate anion per liter of blood, treating the blood (e.g., by dialysis and hemoperfusion if desired), thereafter infusing a calcium compound into the blood to restore proper calcium ion level and coagulative properties, and returning the blood to the patient. A calcium-free acetate or bicarbonate dialysate is advantageously employed. A charcoal perfusion filter can optionally be used in conjunction with the dialyzer apparatus.