Blood spots on the arms of hemodialysis patients are generally considered to be related to abnormal coagulation function and anticoagulants for dialysis. 1. Abnormal coagulation function, related to uremic toxins, occurs with abnormal platelet function and number, both of which can lead to bleeding in superficial areas such as skin mucosa; abnormal coagulation function leads to bleeding in deep tissues such as muscle joints. Increasing the adequacy of dialysis can improve the bleeding tendency of patients. 2. Anticoagulants on dialysis, such as heparin and low molecular heparin, etc. Systemic heparinization on dialysis increases the risk of bleeding in the blood body, such as bleeding from the skin and mucous membranes, gastrointestinal bleeding, cerebral hemorrhage, and heparin-induced thrombocytopenia, etc. This is the time to assess the coagulation situation out of the dialysis, and to re-adjust the dose of heparin, dialyze without heparin, or change the anticoagulant. Hemodialysis patients presenting with blood spots on the arms are advised to consult the dialysis unit physician who will adjust and administer medication accordingly.