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Evaluation of nafamostat mesilate as an alternative anticoagulant during intermittent hemodialysis in healthy Beagle dogs
Author(s) -
Choi Joonhyuk,
Byun Seokyeong,
Nam Aryung,
Han Seimyoung,
Lee Kyupil,
Song Kunho,
Youn Hwayoung,
Seo Kyoungwon
Publication year - 2018
Publication title -
journal of veterinary emergency and critical care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.886
H-Index - 47
eISSN - 1476-4431
pISSN - 1479-3261
DOI - 10.1111/vec.12696
Subject(s) - beagle , medicine , hemodialysis , intensive care medicine , anticoagulant
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.