The role of nafamostat mesylate in continuous renal replacement therapy among patients at high risk of bleeding.

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Baek NN, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Lee JE

The role of nafamostat mesylate in continuous renal replacement therapy among patients at high risk of bleeding.

Ren Fail. 2012;34(3):279-85. doi: 10.3109/0886022X.2011.647293. Epub 2012 Jan 17.

PubMed ID

22251267 [ View in PubMed

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Abstract

Continuous renal replacement therapy (CRRT) has emerged as the preferred dialysis modality for critically ill patients with acute kidney injury. The objectives of this retrospective study were to assess the effect of nafamostat on circuit patency of CRRT and the safety regarding bleeding complications in patients at high risk of bleeding. We conducted a retrospective study of 243 CRRT patients at high risk of bleeding. We started CRRT without anticoagulation, and nafamostat was used if hemofilter lifespan was less than 12 h. The average hemofilter lifespan was measured before and after drug infusion to evaluate the efficacy of nafamostat. The frequency and number of red blood cell (RBC) transfusions were measured to assess the safety of nafamostat. Of the 243 patients, 62 (25.5%) received nafamostat. In nafamostat group, the hemofilter lifespan was lengthened from 10.2 (7.5-13.0) h to 19.8 (12.6-26.6) h after drug infusion (p < 0.001). The hemofilter lifespan was 27.5 (17.5-38.2) h in anticoagulation-free group. The frequency of RBC transfusion during CRRT did not differ between the nafamostat group and the anticoagulation-free group (71% vs. 70%, p = NS). The median number of RBC units transfused per CRRT day was also not different between the two groups [0.7 (0.5-1.0) units/day vs. 0.7 (0.4-1.1) units/day; p = NS]. The use of nafamostat in patients at high risk of bleeding who require CRRT effectively lengthened the filter survival time without an increase in RBC transfusion. However, 74.5% of patients at high risk of bleeding maintained an acceptable CRRT hemofilter lifespan without circuit anticoagulation.

DrugBank Data that Cites this Article

Drug Targets

Drug	Target	Kind	Organism	Pharmacological Action	Actions
Nafamostat	Coagulation factor X	Protein	Humans	Yes	Inhibitor	Details
Nafamostat	Coagulation factor XII	Protein	Humans	Yes	Inhibitor	Details