Low-Dose Nafamostat Mesilate in Hemodialysis Patients at High Bleeding Risk.
- Author:
Eun Yi KIM
1
;
Young Ki LEE
;
Seung Min LEE
;
Myung Jin CHOI
;
Young Rim SONG
;
Soo Jin KIM
;
Tae Jin PARK
;
Sung Gyun KIM
;
Jieun OH
;
Jang Won SEO
;
Jong Woo YOON
;
Ja Ryong KOO
;
Hyung Jik KIM
;
Jung Woo NOH
Author Information
1. Dialysis Center, College of Medicine, Hallym University, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Nafamostat;
Anticoagulation;
Renal dialysis
- MeSH:
Dialysis;
Guanidines;
Hemorrhage;
Heparin;
Humans;
Mesylates;
Renal Dialysis;
Thrombosis
- From:Korean Journal of Nephrology
2011;30(1):61-66
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: Systemic anticoagulation, usually with heparin, is required to prevent thrombosis in the blood circuit of hemodialysis. In patients at high bleeding risk, strategies to minimize the bleeding risk include heparin-free or regional anticoagulation methods. Nafamostat mesilate with conventional dose (35 mg/hr) has been used for this purpose. But it is an expensive anticoagulant to use conveniently for the dialysis therapy. Application of low-dose nafamostat mesilate has almost never been tried yet on hemodiaysis management. In this study, we examined the effect of low-dose nafamostat mesilate compared to heparin-free in hemodialysis patients with high risk of bleeding. METHODS: The current study was conducted on 35 hemodialysis patients with high bleeding risk (on-going bleeding, hemorrhage, surgery or severe thrombocytopenia). In the low-dose nafamostat group (n=17, mean age: 59+/-15 years), 238 sessions were performed with continuous infusion of nafamostat mesilate (12.5 mg/hr). In the control group with saline-flushing no heparin methods (n=18, mean age: 57+/-17 years), 247 sessions were analyzed. RESULTS: No significant differences were found in baseline characteristics between the low-dose nafamostat group and the saline group. In the progress of bleeding complications, there were no significant differences between the two groups (11.8% vs. 11.1%). In saline group, however, massive clotting occurred in 44.5 per 1000 sessions, while it occurred in 4.2 per 1000 sessions in the low-dose nafamostat group (p=0.006). CONCLUSION: In patients at high bleeding risk, low-dose nafamostat mesilat can be used as an inexpensive, effective, and safe anticoagulant for hemodialysis.
