Sixty patients with sepsis treated by CVVH were divided into control group （initial dose of sodium citrate was 1.3 × blood flow velocity） and observation group （initial dose of sodium citrate was 1.5 × blood flow velocity）. The relative pressure parameters of hemofilters，sodium citrate anticoagulation parameters and the occurrence of adverse events were compared between the two groups.

The pre-filter pressure，transmembrane pressure，and filtration pressure drop of the two groups increased after 4 hours of CVVH treatment. The level of transmembrane pressure and filtration pressure drop in the observation group was lower than that of the control group （P< 0.05）. There was no difference in pre-filter pressure between the two groups （P> 0.05）. After CVVH treatment for 2 h and 4 h，the relative rates of Ca²⁺and sodium citrate after the filter in the observation group were higher than those in the control group， while the rate of Ca²⁺failure after the filter was lower than that in the control group （P< 0.05）. After treatment，the levels of calcium （Ca²⁺）， sodium （Na⁺），bicarbonate （HCO₃^-） and platelet count （PLT） in the two groups did not change significantly，and there was no significant difference between the two groups （P> 0.05）. The levels of activated partial prothrombin time （APTT） in the two groups increased （P< 0.05）， but there was no difference between the two groups （P> 0.05）. There was 1 case （3.33%） in the observation group （3.33%） with coagulation in the tube/filter，and 6 cases （20.00%） in the control group. There was a significant difference between the two groups （χ²= 4.043，P= 0.044）.

High-dose sodium citrate during CVVH treatment of sepsis has positive significance in controlling hemofilter pressure-related parameters and reducing the occurrence of thrombosis-related complications，and does not increase the occurrence of metabolic alkalosis and hypernatremia.