Evaluation of the Pharmacokinetics of Nafamostat Mesylate during Continuous Renal Replacement Therapy  

作　　者：Koji Konishi Satoki Inoue Masahiko Kawaguchi Koji Konishi;Satoki Inoue;Masahiko Kawaguchi(Department of Clinical Engineering, Nara Medical University Hospital, Nara, Japan;Department of Anesthesiology, Fukushima Medical University Hospital, Fukushima, Japan;Department of Anesthesiology, Nara Medical University Hospital, Nara, Japan)

机构地区：[1]Department of Clinical Engineering, Nara Medical University Hospital, Nara, Japan [2]Department of Anesthesiology, Fukushima Medical University Hospital, Fukushima, Japan [3]Department of Anesthesiology, Nara Medical University Hospital, Nara, Japan

出　　处：《Open Journal of Emergency Medicine》2022年第4期157-167,共11页急诊医学（英文）

摘　　要：Continuous renal replacement therapy (CRRT) is the preferred dialysis modality in critical care settings for patients with hemodynamic instability. Nafamostat mesylate (NM) is an anticoagulant commonly used (mainly in Japan) during CRRT in patients with high bleeding risk. In this study, we evaluated the pharmacokinetics of NM during CRRT. Patients undergoing CRRT therapy and using NM as the anticoagulant in the intensive care unit were enrolled in the study. Blood was collected from the CRRT circuit just after blood removal, just before and after the membrane for CRRT, and from the filtrates after the membrane. NM concentrations were measured using high-performance liquid chromatography. NM was detected in the intracorporeal circulation during CRRT in some cases, and liver enzymes were severely elevated in almost all of the cases. Coagulation time was prolonged even before the initiation of NM administration in these cases and may be associated with liver damage. This study suggests that NM dosage should take into account liver damage assessed by elevated liver enzymes.Continuous renal replacement therapy (CRRT) is the preferred dialysis modality in critical care settings for patients with hemodynamic instability. Nafamostat mesylate (NM) is an anticoagulant commonly used (mainly in Japan) during CRRT in patients with high bleeding risk. In this study, we evaluated the pharmacokinetics of NM during CRRT. Patients undergoing CRRT therapy and using NM as the anticoagulant in the intensive care unit were enrolled in the study. Blood was collected from the CRRT circuit just after blood removal, just before and after the membrane for CRRT, and from the filtrates after the membrane. NM concentrations were measured using high-performance liquid chromatography. NM was detected in the intracorporeal circulation during CRRT in some cases, and liver enzymes were severely elevated in almost all of the cases. Coagulation time was prolonged even before the initiation of NM administration in these cases and may be associated with liver damage. This study suggests that NM dosage should take into account liver damage assessed by elevated liver enzymes.

关 键 词：Nafamostat Mesylate Continuous Renal Replacement Therapy Liver Dysfunction 

分 类 号：R47[医药卫生—护理学]