Nafamostat Mesylate Versus Regional Citrate Anticoagulation for Continuous Renal Replacement Therapy in Patients at High Risk of Bleeding: a Retrospective Single-center Study

Overview

Journal Eur J Med Res

Publisher Biomed Central

Specialty General Medicine

Date 2024 Jan 20

PMID 38245802

Authors

Dan Liu

Jian Zhao

Hui Xia

Shi Dong

Songjuan Yan

Yugang Zhuang

Yuanzhuo Chen

Hu Peng

Affiliations

Soon will be listed here.

Abstract

Purpose: The choice of continuous renal replacement therapy (CRRT) anticoagulation program for patients at high risk of bleeding has always been a complex problem in clinical practice. Clinical regimens include regional citrate anticoagulation (RCA) and nafamostat mesylate (NM). This study aimed to evaluate the efficacy and safety of these two anticoagulants for CRRT in patients at high risk of bleeding to guide their clinical use better.

Patients And Methods: Between January 2021 and December 2022, 307 patients were screened for this study. Forty-six patients were finally enrolled: 22 in the regional citrate anticoagulation group and 24 in the nafamostat mesylate group. We collected patients' baseline characteristics, laboratory indicators before CRRT, and CRRT-related data. We then performed a statistical analysis of the data from both groups of patients.

Results: In our study, the baseline characteristics did not differ significantly between the two groups; the baseline laboratory indicators before CRRT of patients in the two groups were not significantly different. The duration of CRRT was 600 min in the regional citrate anticoagulation (RCA) group, 615 min in the nafamostat mesylate (NM) group; the success rate was 90.7% in the RCA group, and 85.6% in the NM group, the anticoagulant efficacy between the two groups was comparable. There was no significant difference in the safety of anticoagulation between the two groups. We used Generalized Estimating Equations (GEE) to test whether different anticoagulation methods significantly affected the success rate of CRRT and found no statistical difference between RCA and NM.

Conclusion: Our study suggests that nafamostat mesylate's anticoagulant efficacy and safety are not inferior to regional citrate anticoagulation for continuous renal replacement therapy in patients at high risk of bleeding.

Citing Articles

Nafamostat mesylate versus regional citrate anticoagulation for chronic hemodialysis in patients at high risk of bleeding: a single-center, retrospective study.

Li J, Wang L, Lu Y, Zhou Y, Chen Y Ren Fail. 2025; 47(1):2464830.

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