2025 Volume 16 Issue 1 Pages 24-28
Objective: The AN69ST hemofilter, because of its negatively charged surface, adsorbs the anticoagulant, nafamostat mesilate (NM). However, temporal changes in NM adsorption capacity have not yet been reported. A decline in this capacity may increase the risk of bleeding. This study aimed to evaluate the temporal changes in NM adsorption capacity. Methods: Using the Prismaflex multipurpose blood purification system, NM was administered exclusively through the afferent blood circuit of an AN69ST hemofilter (membrane area; 1.5 m2). Activated coagulation time (ACT) was measured in the arterial and venous line blood circuits in 74 patients. The duration from the initiation of continues kidney replacement therapy (CKRT) to ACT measurement was stratified into six intervals, and the ACT values on the venous line blood side were compared across these time points. Results: The ACT on the venous line blood side was observed as follows (median [interquartile range]): at 12 hours, 162 s (IQR 145, 185); at 12-24 h, 201 s (IQR 178, 227); at 24-36 s, 229 s (IQR 190, 263); at 36-48 hours, 246 s (IQR 224, 274); at 48-60 h, 248 s (IQR 229, 302); and beyond 60 h, 249 s (IQR 228, 267). A statistically significant prolongation was observed compared to baseline (P<0.01). Conclusion: The NM adsorption capacity of the AN69ST hemofilter was suggested to decrease over time.
