PMID- 26868216
OWN - NLM
STAT- MEDLINE
DCOM- 20170120
LR  - 20211203
IS  - 1724-6040 (Electronic)
IS  - 0391-3988 (Linking)
VI  - 39
IP  - 1
DP  - 2016 Jan
TI  - Comparison of nafamostat mesilate and unfractionated heparin as anticoagulants 
      during continuous renal replacement therapy.
PG  - 16-21
LID - 10.5301/ijao.5000465 [doi]
AB  - PURPOSE: Nafamostat mesilate (NM) can be used as a regional anticoagulant for 
      continuous renal replacement therapy (CRRT). The primary aim of this study was to 
      assess the association of the use of NM with risk of bleeding complications and 
      compare it with the use of unfractionated heparin (UFH). METHODS: We conducted a 
      single-center retrospective observational study. We included adult patients who 
      required CRRT in our intensive care unit from 2011 to 2013. The primary outcome 
      was the risk of bleeding complications during CRRT and the secondary outcome was 
      filter life for the first filter of CRRT. RESULTS: We included 101 patients (76 
      with NM, 25 with UFH). Among the 101 patients, use of NM tended to be associated 
      with lower risk of bleeding complications (6.6% vs. 16%; odds ratio, 0.37; p = 
      0.16). Propensity score matching generated 30 patients with NM and 15 patients 
      with UFH with well-balanced baseline characteristics. Among the propensity 
      score-matched cohorts, use of NM was significantly associated with decreased risk 
      of bleeding complications (3.3% vs. 27%; odds ratio, 0.09; p = 0.04). In 
      multivariate logistic analysis using the inverse probability of treatment 
      weighting for sensitive analysis, the use of NM was independently associated with 
      reduced risk of bleeding complications (p = 0.02). The median filter life was not 
      significantly different for patients with NM and patients with UFH (25.5 hours 
      vs. 30.5 hours, p = 0.16). CONCLUSIONS: In our retrospective analysis, the use of 
      NM as an anticoagulant during CRRT was associated with decreased incidence of 
      bleeding complications compared with the use of UFH.
FAU - Makino, Shohei
AU  - Makino S
AD  - Department of Anesthesiology, Kobe University Hospital, Kobe - Japan.
FAU - Egi, Moritoki
AU  - Egi M
AD  - Department of Anesthesiology, Kobe University Hospital, Kobe - Japan.
FAU - Kita, Hiroshi
AU  - Kita H
AD  - Department of Clinical Engineering, Kobe University Hospital, Kobe - Japan.
FAU - Miyatake, Yuji
AU  - Miyatake Y
AD  - Post Graduate Student of Division of Anesthesiology, Department of Surgery 
      Related, Kobe University Graduate School of Medicine, Kobe - Japan.
FAU - Kubota, Kenta
AU  - Kubota K
AD  - Department of Anesthesiology, Kobe University Hospital, Kobe - Japan.
FAU - Mizobuchi, Satoshi
AU  - Mizobuchi S
AD  - Division of Anesthesiology, Department of Surgery Related, Kobe University 
      Graduate School of Medicine, Kobe - Japan.
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Observational Study
DEP - 20160209
PL  - United States
TA  - Int J Artif Organs
JT  - The International journal of artificial organs
JID - 7802649
RN  - 0 (Anticoagulants)
RN  - 0 (Benzamidines)
RN  - 0 (Guanidines)
RN  - 9005-49-6 (Heparin)
RN  - Y25LQ0H97D (nafamostat)
SB  - IM
MH  - Acute Kidney Injury/*therapy
MH  - Aged
MH  - Aged, 80 and over
MH  - Anticoagulants/*adverse effects/therapeutic use
MH  - Benzamidines
MH  - Critical Care
MH  - Female
MH  - Guanidines/*adverse effects/therapeutic use
MH  - Hemorrhage/*chemically induced/prevention & control
MH  - Heparin/*adverse effects/therapeutic use
MH  - Humans
MH  - Intensive Care Units
MH  - Male
MH  - Middle Aged
MH  - Propensity Score
MH  - *Renal Replacement Therapy/instrumentation
MH  - Retrospective Studies
MH  - Risk Assessment
EDAT- 2016/02/13 06:00
MHDA- 2017/01/21 06:00
CRDT- 2016/02/13 06:00
PHST- 2016/01/15 00:00 [accepted]
PHST- 2016/02/13 06:00 [entrez]
PHST- 2016/02/13 06:00 [pubmed]
PHST- 2017/01/21 06:00 [medline]
AID - 786C8308-1B8B-4183-AA81-70D77911DC81 [pii]
AID - 10.5301/ijao.5000465 [doi]
PST - ppublish
SO  - Int J Artif Organs. 2016 Jan;39(1):16-21. doi: 10.5301/ijao.5000465. Epub 2016 
      Feb 9.