2020 Volume 46 Issue 10 Pages 561-566
Nafamostat mesilate (NM) is used clinically for the prevention and treatment of pancreatitis. Electrolyte monitoring is necessary in geriatric patients receiving NM as it may cause hyperkalemia with the possibility of inducing arrhythmias. We attempted to evaluate the risk of hyperkalemia with aging and its background in this retrospective cohort study. Thirty-six of 290 patients (12.4％) who were receiving NM for the prevention and treatment of pancreatitis experienced hyperkalemia at the Kanazawa Medical Center over the past 2 years. A multiple logistic regression analysis was performed to identify the risk factors for hyperkalemia. The results showed that significant predictors of hyperkalemia were increasing age (per 10 years; odds ratio [OR]: 1.41, 95％ confidence interval [CI]: 1.01 - 1.96, P < 0.045), fever (OR: 3.11, 95％ CI: 1.25 - 7.71, P < 0.015), a high daily dose (per 10 mg/body/day; OR: 1.10, 95％ CI: 1.01 - 1.20, P < 0.038), and a high serum potassium level at the start of treatment (per mEq/L; OR: 2.86, 95％ CI: 1.40 - 5.83, P < 0.004). Thus, prior to the initiation of treatment with NM, it is necessary to assess the patient’s medical background and to perform electrolyte monitoring frequently. We suggest that dosage reduction should be considered in the treatment of geriatric patients undergoing long-term treatment with NM.
