Pharmacokinetics of nafamostat mesilate during continuous hemodiafiltration with a polyacrylonitrile membrane.
We studied the pharmacokinetics of nafamostat mesilate (NM) used as an anticoagulant in continuous hemodiafiltration (CHDF) with a polyacrylonitrile (PAN) membrane used as the hemofilter. Six patients undergoing CHDF for multiple organ dysfunction syndrome (MODS) were chosen as subjects. The inlet NM concentration measured 24 h after the start of CHDF was significantly greater than that after 1 h (P = 0.0431). No significant difference was observed between the outlet NM concentration and the ultrafilter concentration at 1 h or 24 h after the start of CHDF. However, concentrations at 24 h differed significantly from concentrations at 1 h at all sites. Significant correlation was observed between the dose of NM and the outlet NM concentration (P = 0.0475). No statistical correlation was observed between the dose of catecholamines and the outlet NM concentration (P = 0.0985). This study is the first to disclose a mild but significant time-dependent serum NM concentration in patients with MODS.
Nakae
Hajime
H
Department of Integrated Medicine, Division of Emergency and Critical Care Medicine, Akita University School of Medicine, Akita, Japan. nakaeh@doc.med.akita-u.ac.jp
Tajimi
Kimitaka
K
D000180:Acrylic Resins; D000368:Aged; D000925:Anticoagulants / Q000493:pharmacokinetics*; D001550:Benzamidines; D002395:Catecholamines / Q000494:pharmacology; D004347:Drug Interactions; D005260:Female; D006146:Guanidines / Q000493:pharmacokinetics*; D017583:Hemodiafiltration; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D009102:Multiple Organ Failure / Q000628:therapy
D000180:Acrylic Resins; D000925:Anticoagulants; D001550:Benzamidines; D002395:Catecholamines; D006146:Guanidines; D008567:Membranes, Artificial; C010504:polyacrylonitrile; C032855:nafamostat