ArticleKidney research and clinical practice2024
The role of nafamostat mesylate anticoagulation in continuous kidney replacement therapy for critically ill patients with bleeding tendencies: a retrospective study on patient outcomes and safety.
Article in Kidney research and clinical practice, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Nafamostat mesilate as anticoagulant for blood purification: a systematic review and meta-analysis.Critical care (London, England) · 2025Pooled it
- Efficacy and safety of nafamostat mesilate in pediatric continuous renal replacement therapy: a 5-year retrospective study in South Korea.Childhood kidney diseases · 2026Article
- Korean Society of Nephrology 2025 evidence-based clinical practice guideline for continuous kidney replacement therapy.Kidney research and clinical practice · 2026Article
- Korean Society of Nephrology 2025 Evidence-Based Clinical Practice Guideline for Continuous Kidney Replacement Therapy.Electrolyte & blood pressure : E & BP · 2026Review
- Comparison of the efficacy and safety of nafamostat mesylate and heparin in blood purification therapy for patients with severe acute pancreatitis: protocol for a randomized controlled trial.Frontiers in medicine · 2026Article
- Optimizing a Dose Prescription as the First Step of Green Continuous Kidney Replacement Therapy.Kidney medicine · 2025Article
- The 5th Asia Pacific AKI CRRT 2023: Best Movement to Critical Care, Save Lives.Kidney research and clinical practice · 2024Article
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9 authors.
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Abstract
backgroundContinuous kidney replacement therapy (CKRT) is crucial in the management of acute kidney injury in intensive care units (ICUs). Nonetheless, the optimal anticoagulation strategy for patients with bleeding tendencies remains debated. This study aimed to evaluate patient outcomes and safety of nafamostat mesylate (NM) compared with no anticoagulation (NA) in critically ill patients with bleeding tendencies who were undergoing CKRT.
methodsThis retrospective study enrolled 2,313 patients who underwent CKRT between March 2013 and December 2022 at the third affiliated hospital in South Korea. After applying the exclusion criteria, 490 patients were included in the final analysis, with 245 patients in the NM and NA groups each, following 1:1 propensity score matching. Subsequently, in-hospital mortality, incidence of bleeding complications, agranulocytosis, hyperkalemia, and length of hospital stay were assessed.
resultsNo significant differences were observed between the groups regarding the lengths of hospital and ICU stays or the incidence of agranulocytosis and hyperkalemia. The NM group showed a smaller decrease in hemoglobin levels during CKRT (-1.90 g/dL vs. -2.39 g/dL) and less need for blood product transfusions than the NA group. Furthermore, the NM group exhibited a survival benefit in patients who required transfusion of all three blood products.
conclusionNM is an effective and safe anticoagulant for CKRT in critically ill patients, especially those requiring transfusion of all three blood products. Although these findings are promising, further multicenter studies are needed to validate them and explore the mechanisms underlying the observed benefits.
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