Predilution online hemodiafiltration with Citrasate - is it a possible option for heparin free procedure?

This study tests whether kidney dialysis patients can safely undergo a 4-hour treatment session called online hemodiafiltration (a very effective form of dialysis that cleans the blood more thoroughly) without needing any blood-thinning medication (anticoagulation). The special dialysis fluid used — called Citrasate — may naturally help prevent clotting in the machine during the procedure. Researchers will check whether the treatment can be completed safely and will measure markers in the blood that show whether clotting was triggered. You may be eligible if: - You have end-stage chronic kidney disease (stage 5) and have been on dialysis for more than 3 months - You have a functioning arteriovenous fistula (a connection created in your arm for dialysis) that provides good blood flow - You are 18 years of age or older - You are male or female You may NOT be eligible if: - You have liver disease (elevated liver enzymes more than double the normal limit) - You have a bleeding or clotting disorder, or a low platelet count (below 100,000) - You are on any blood-thinning medication other than aspirin - You have cancer Talk to your doctor about whether this trial might be right for you.