SynthesisCritical care (London, England)2025
Nafamostat mesilate as anticoagulant for blood purification: a systematic review and meta-analysis.
Synthesis in Critical care (London, England), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
5 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Comparing the efficacy and safety of nafamostat mesylate versus citrate for anticoagulation in continuous renal replacement therapy: a systematic review and meta-analysis.Frontiers in medicine · 2026Pooled it
- Implementation quality as a modifiable determinant of filter lifespan in regional citrate anticoagulation: a real-world clustering-adjusted study.Renal failure · 2026Article
- Nafamostat mesylate versus low-molecular-weight heparin during continuous renal replacement therapy in critically Ill adults: a single-center retrospective cohort study.BMC nephrology · 2026Article
- Nafamostat mesilate for anticoagulation in pediatric trauma patients undergoing extracorporeal membrane oxygenation: a two-center observational study in Northwest China.Frontiers in medicine · 2026Article
- Case Report: Navigating the bleeding-thrombosis paradox: regional nafamostat anticoagulation in a post-intracerebral hemorrhage patient on VV-ECMO.Frontiers in medicine · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
11 authors.
Funding
Abstract
objectiveThe nafamostat mesilate (NM) has shown good safety and effectiveness as anticoagulant for blood purification. This systematic review and meta-analysis aims to comprehensively compare NM with other anticoagulation strategies during blood purification.
methodWe searched the electronic databases of PubMed, Web of Science, Cochrane and Embase before 6 May 2025 on the application of NM in comparison with conventional anticoagulants, including unfractionated heparin, low-molecular-weight heparin, and regional citrate, or non-anticoagulant (NA) during blood purification. The protocol was registered in PROSPERO (CRD420251110062). We compared the incidence of bleeding, clotting and mortality with risk ratio (RR) and confidence intervals (95% CIs). Mean differences (MDs) with 95% CIs were employed for the comparisons of filter life and hospitalization length. Subgroup analysis was conducted according to the specific type of conventional anticoagulants and extracorporeal modalities of blood purification. Assessment of study quality, and sensitivity and publication bias analyses were conducted.
resultIn total, 16 studies consisting of 4349 participants were included in this systematic review and meta-analysis. Of them, 3956 patients received renal replacement therapy, and 393 underwent extracorporeal membrane oxygenation. NM showed a significantly lower risk of bleeding (RR: 0.53, 95% CI: 0.29-0.97, P = 0.040) and comparable filter life (MD: -1.23 h, 95% CI: -4.27-1.81, P = 0.428) compared with conventional anticoagulants. In comparison with NA, NM demonstrated a substantially longer filter life (MD: 4.84 h, 95% CI: 0.18-9.51, P = 0.042) and similar risk for bleeding complication (RR = 0.49, 95% CI: 0.18-1.35, P = 0.170). Of note, it was also associated with lower in-hospital mortality compared with NA (RR: 0.87, 95% CI: 0.77-0.97, P = 0.015).
conclusionNM is a safe and effective anticoagulant for blood purification, showing lower bleeding risk than conventional anticoagulants and longer filter life than NA, which is particularly suitable for patients at high risk of bleeding.
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