Prevention of clotting in the extracorporeal circuit is an important concern in maintenance hemodialysis patients, and can be achieved by anticoagulation administration pre dialysis. Underdosing however may lead to hemodialyser clotting, subsequent reduced dialysis efficiency, and even loss of the dialysis circuit and patient’s extracorporeal blood volume. Overdosing may results in drug accumulation, hemorrhage, and lower Health Related Quality of Life. Anticoagulation management in this patient group is further hampered by the subtle balance between a prothrombotic state and a bleeding risk. Accurate tools to objectively assess extracorporeal coagulation are however lacking. However, we recently developed a new gold standard micro-CT scanning protocol of dialyzers. Associating these micro-CT results with machine or patient related clotting parameters can help us in finding a marker to quantify patient-specific anticoagulation.