Evaluation of the Anticoagulant Efficacy and Safety of Nafamostat Mesylate in Hemodialysis Patients

Expand
  • Qidong Hospital, Affiliated to Nantong University, Jiangsu Nantong 226200, China

Received date: 2026-01-07

  Revised date: 2026-03-11

  Accepted date: 2026-08-05

  Online published: 2026-08-12

Abstract

Objective: To evaluate the anticoagulant efficacy and safety of nafamostat mesylate (NM) in patients undergoing hemodialysis. Methods: A total of 100 patients undergoing hemodialysis in our hospital between January 2023 and August 2024 were randomly assigned to either the observation group (NM) or the control group (standard anticoagulant heparin), with 50 patients in each group. The anticoagulant efficacy, coagulation function, acid-base balance, and plasma electrolyte levels were compared between the two groups. Results: The total effective rate of anticoagulation in the observation group was 90.0%, higher than that of the control group(60.0%) (P<0.001). The observation group showed less fibrin deposition in the dialyzer and tubing, and more stable coagulation function (P>0.05). The APTT in vivo of the observation group was significantly prolonged at 2, 4 h after dialysis (P<0.05). The coagulation function of the observation group was better than that of the control group 4 h after dialysis (P<0.05). There was no statstic difference in pH, Na+, K+and other acid-base balance, electrolyte levels, and bleeding complications between the two groups before and after dialysis (P>0.05). Conclusion: Nafamostat mesylate demonstrates superior anticoagulant efficacy compared to traditional anticoagulants in hemodialysis, with a higher safety profile. NM effectively prevents fibrin deposition during dialysis, maintains the patency of the dialyzer, and reduces bleeding risks.

Cite this article

CHEN Chen, GONG Xuelian, HUANG Yan, SHEN Qingyun . Evaluation of the Anticoagulant Efficacy and Safety of Nafamostat Mesylate in Hemodialysis Patients[J]. CHINESE JOURNAL OF DRUG EVALUATION, 2026 , 43(3) : 226 -226-230 . DOI: 10.2095-3593.2026.060003

References

 [1] George C, Kengne AP. Advances in the diagnosis, treatment, and prognosis of chronic kidney disease: a reflection on recent developments[J]. Applied Sciences, 2024, 14(13): 5518.
     [2] Kameda S, Fujii T, Ikeda J, et al. Unfractionated heparin versus nafamostat mesylate for anticoagulation during continuous kidney replacement therapy: an observational study[J]. BMC Nephrol, 2023, 24(1): 12.
     [3] Kameda S, Maeda A, Maeda S, et al. Dose of nafamostat mesylate during continuous kidney replacement therapy in critically ill patients: a two-centre observational study[J]. BMC Nephrol, 2024, 25(1): 69.
     [4] Liu D, Zhao J, Xia H, et al. Nafamostat mesylate versus regional citrate anticoagulation for continuous renal replacement therapy in patients at high risk of bleeding: a retrospective single-center study[J]. Eur J Med Res, 2024, 29(1): 72.
     [5] Wang X, Ji X. Sample size estimation in clinical research: from randomized controlled trials to observational studies[J]. Chest, 2020, 158(1): S12-S20.
     [6] Vanommeslaeghe F, Van Biesen W, Franois K. Detection and scoring of extracorporeal circuit clotting during hemodialysis[C]//Seminars in Nephrology. WB Saunders, 2024: 151474.
     [7] Smythe MA, Priziola J, Dobesh PP, et al. Guidance for the practical management of the heparin anticoagulants in the treatment of venous thromboembolism[J]. J Thromb Thrombolysis, 2016, 41(1): 165-186.
     [8] Crowther MA, Warkentin TE. Bleeding risk and the management of bleeding complications in patients undergoing anticoagulant therapy: focus on new anticoagulant agents[J]. Bloody, 2008, 111(10): 4871-4879.
     [9] 杨振华,陈秋馨,李倩玉,等. 甲磺酸萘莫司他体外抗凝在血液透析高危出血风险患者中的应用观察[J]. 中国血液净化, 2024, 23(9): 651-654,662.
     [10] Chen P, Zhao LJ, Huang L, et al. Nafamostat mesilate prevented caerulein-induced pancreatic injury by targeting HDAC6-mediated NLRP3 inflammasome activation[J]. Inflamm Res, 2023, 72(9): 1919-1932.
     [11] 蒋秋艳,王保瑶,张梦婷,等. 甲磺酸萘莫司他抗凝在肾移植术后肾功能延迟恢复患者血液透析中的应用[J]. 中国中西医结合肾病杂志, 2024, 25(8):698-700.
     [12] Tsujimoto Y, Fujii T. How to prolong filter life during continuous renal replacement therapy?[J]. Critical Care, 2022, 26(1): 62.
     [13] Qian Y, Wu W, Wang M, et al. How do filter types of renal replacement therapy affect survival in critically ill patients? Concerns about adsorption of nafamostat mesylate on AN69 membranes[J]. BMC Nephrol, 2024, 25(1): 314.
     [14] Tang JY, Yang L, Wang J, et al. Nafamostat mesylate has advantages as an anticoagulant for patients undergoing maintenance hemodialysis with conjunctival bleeding[J]. Clin Kidney J, 2024, 17(7):sfae175.
     [15] 陈势,黄嫣然,杨坤. 甲磺酸萘莫司他与枸橼酸在高危出血患者CRRT中抗凝有效性和安全性对比研究[J]. 实用休克杂志(中英文), 2024, 8 (2): 89-92,103.
     [16] 庄冰,叶红,曹红娣,等. 注射用甲磺酸萘莫司他用于血液透析抗凝治疗的多中心随机对照研究[J]. 中国血液净化, 2022, 21 (10): 739-743.
Outlines

/

[an error occurred while processing this directive]