2018 Volume 9 Issue 2 Pages 116-120
The site and dose of nafamostat mesilate (NM) administration were examined in patients undergoing continuous hemodiafiltration (CHDF) using the AN69ST membrane hemofilter. Patients who were administered NM pre-hemofilter (group A) were compared with those who were administered NM post-hemofilter in addition to pre-hemofilter (group AV). In both groups, activated coagulation time on the blood return side was not elongated in comparison with the blood removal side. Coagulation in the circuit occurred 8 times in group A, and 9 times in group AV, but in the drip-chamber of the blood return side alone in 6 of 8 times in group A and 6 of 9 times in group AV. Group A showed distinct changes in circuit pressure due to circuit coagulation in the vein-side chamber when compared with Group AV. NM is adsorbed on the AN69ST membrane hemofilter and may exert an anticoagulant effect on the membrane. Increasing the post-hemofilter NM dose may also reduce circuit coagulation； however, the resulting increase in the total NM dose may increase the risk of bleeding and cost. Therefore, further investigation including cost-benefit analysis is necessary when CHDF using an AN69ST membrane hemofilter is adopted.
