Introduction: We aimed to evaluate continuous venovenous haemofiltration (CVVH) versus continuous venovenous haemodialysis without filtration (CVVHD) - using citrate as regional anticoagulation - on solute clearance, nurse workload, and costs. Methods: Prospective crossover study in a cohort of ICU patients with acute kidney injury. We compared urea, creatinine and β2-microglobulin clearance, filter lifespan and membrane performance over 72 hours (maximal filter runtime) during 15 CVVH and 15 CVVHD sessions. Anticoagulation was performed with tri-sodium citrate. Direct costs were calculated per 72 hours. Values indicate median and [P25-P75]. Results: Thirty filter runs were evaluated in 15 patients (9 male) with acute kidney injury (age 70 [59-76]). During CVVH, urea and creatinine clearances (34 [34-36] and 31 [27-33] ml/min) were comparable with CVVHD (32 [25-33] and 25[20-30] ml/ min, respectively; p=0.117 and p=0.041). The clearance of β2-microglobulin was higher during CVVH (20 [16-22] ml/min) than during CVVHD (13 [12-14] ml/min; p=0.006). With a maximum allowed filter runtime of 72 hours, the filter survival time was longer during CVVHD (72 [4-73 h]) than during CVVH (43 [17-66 h]; p=0.004). CVVHD was considered less time-consuming and more user friendly than CVVH by most nurses, with less down time moments. Costs per 72 hours were lower during CVVHD: €1073 [€1072-€1146] than during CVVH €1427 [1225-1551]; p=0.002, with a cost saving of €354 [€153-€405]. Conclusion: During locoregional citrate anticoagulation, CVVHD is similarly effective, easier to handle and more cost-effective than standard CVVH. © 2017, Netherlands Society of Intensive Care. All rights reserved.