2020 Volume 11 Issue 1 Pages 68-72
The AN69ST membrane hemofilter has been reported to absorb nafamostat mesilate (NM). To prevent such absorptions, our hospital adopts a 2-way method wherein NM is injected into the venous side as well. The success rate of the conventional 2-way method was as high as 94% when dialysis was performed with 1 hemofilter for 22 hours or longer, but the required dose of NM was high 41.0 ± 9.7 mg/hr. Activated clotting time before and after the hemofilter was not extended, but the venous chamber was the site of the coagulation in all subjects in whom the target could not be achieved; notably, no coagulation was observed in the hemofilter. Based on the above findings, we inferred that the AN69ST membrane was a hemofilter with excellent anticoagulant ability and prepared a new protocol that substantially reduced NM on the arterial side. The target achievement rate of the new protocol was 95％. Compared to the conventional protocol, the NM dose could be reduced by 55％ to 18.5±2.4 mg/hr without increasing the circuit clotting.
