Evaluation of nafamostat mesilate as an alternative anticoagulant during intermittent hemodialysis in healthy Beagle dogs. Issue 2 (8th February 2018)

• Record Type: Journal Article
• Authors: Choi, Joon‐hyuk; Byun, Seok‐yeong; Nam, Aryung; Han, Sei‐myoung; Lee, Kyu‐pil; Song, Kun‐ho; Youn, Hwa‐young; Seo, Kyoung‐won
• Is Part Of: Journal of veterinary emergency and critical care. Volume 28:Issue 2(2018)
• Page Start: 122
• Page End: 129
• Publication Date: 2018-02-08
• Subjects: anticoagulation -- canine -- dialysis -- extracorporeal therapy -- kidney injury -- unfractionated heparin; Veterinary emergencies -- Periodicals; Veterinary critical care -- Periodicals; 636.089
• DOI: 10.1111/vec.12696
• Languages: English
• ISSNs: 1479-3261

Abstract

Abstract: Objective: To evaluate nafamostat mesilate (NM) as an alternative anticoagulant agent for intermittent hemodialysis (IHD). Design: Prospective randomized study. Setting: University teaching hospital. Animals: Eighteen healthy Beagle dogs. Interventions: In group 1 ( n = 6), NM was administered at a dose of 0.5 mg/kg/h during IHD for 5 hours. In group 2 ( n = 6), NM was administered at a low dose of 0.25 mg/kg/h during IHD. In group 3 ( n = 6), which was the control group, unfractionated heparin (UFH) was administered during IHD. The evaluated parameters included: the amount of residual blood clots in the blood chamber and arterial side of the dialyzer; the levels of hemoglobin, hematocrit, and platelets; and the prothrombin time (PT), activated partial thromboplastin time (aPTT), and activated clotting time (ACT). Measurements and Main Results: Groups 1 and 2 successfully completed IHD without serious coagulation in the extracorporeal circulation. The residual blood clotting in the blood chamber and arterial side of the dialyzer did not significantly differ in groups 1 and 2 compared to group 3 (group 1 vs group 3, P = 1.000; and group 2 vs group 3, P = 1.000). No significant differences were observed between pre‐ and posttreatment PTs in groups 1 ( P = 0.476) and 2 ( P = 0.597), between pre‐ and posttreatment aPTTs in groups 1 ( P = 0.983) and 2 ( P = 0.977), and between pre‐ and posttreatment ACT in groups 1 ( P = 0.282) and 2 ( P = 0.401). In group 3, a significant elevation of ACT was observed at the posttest ( P < 0.001). Conclusions: The results of this study in healthy Beagle dogs suggest that NM at 0.25 mg/kg/h may be a valid alternative to UFH for IHD. Further studies are needed in patients at high risk of bleeding.