To be honest, Kamal, I have no experience of this option. I can't see it being at all problematic from a renal/dialysis aspect, but I don't know that for certain - it is just my best guess (bolstered by a brief literature search). Will it work? ... no idea, but it clearly HAS been used - some reports suggesting with benefit. But, as best I can find out, it shouldn't be a problem. As for needing to do a heparin-free dialysis preceding the procedure, I find myself agreeing with your orthopaedic surgeon, as I see no issue there. The procedure is pretty atraumatic, is unlikely to be associated with any bleeding, and as the half-life of heparin is short, by the time you are off dialysis and have made it to the surgeon, the effects of heparin will have largely dissipated anyway. I would do your dialysis as planned.