{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:38:11Z","timestamp":1792787891964,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T00:00:00Z","timestamp":1708905600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Grant-in-Aid for Early-Career Scientists","award":["21K16580"],"award-info":[{"award-number":["21K16580"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Nephrol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Nafamostat mesylate is an anticoagulant used for critically ill patients during continuous kidney replacement therapy (CKRT), characterised by its short half-life. However, its optimal dosage remains unclear. This study aimed to explore the optimal dosage of nafamostat mesylate during CKRT.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a two-centre observational study. We screened all critically ill adult patients who required CKRT in the intensive care unit (ICU) from September 2013 to August 2021; we included patients aged\u2009\u2265\u200918 years who received nafamostat mesylate during CKRT. The primary outcome was filter life, defined as the time from CKRT initiation to the end of the first filter use due to filter clotting. The secondary outcomes included safety and other clinical outcomes. The survival analysis of filter patency by the nafamostat mesylate dosage adjusted for bleeding risk and haemofiltration was performed using a Cox proportional hazards model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      We included 269 patients. The mean dose of nafamostat mesylate was 15.8\u00a0mg\/hr (Standard deviation (SD), 8.8; range, 5.0 to 30.0), and the median filter life was 18.3\u00a0h (Interquartile range (IQR), 9.28 to 36.7). The filter survival analysis showed no significant association between the filter life and nafamostat mesylate dosage (hazard ratio 1.12; 95 CI 0.74\u20131.69,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.60) after adjustment for bleeding risk and addition of haemofiltration to haemodialysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We observed no dose-response relationship between the dose of nafamostat mesylate (range: 5 to 30\u00a0mg\/h) and the filter life during CKRT in critically ill patients. The optimal dose to prevent filter clotting safely needs further study in randomised controlled trials.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Not applicable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12882-024-03506-0","type":"journal-article","created":{"date-parts":[[2024,2,26]],"date-time":"2024-02-26T07:02:21Z","timestamp":1708930941000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["Dose of nafamostat mesylate during continuous kidney replacement therapy in critically ill patients: a two-centre observational study"],"prefix":"10.1186","volume":"25","author":[{"given":"Shinya","family":"Kameda","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akinori","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shun","family":"Maeda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaro","family":"Inoue","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazunari","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akira","family":"Kageyama","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent","family":"Doi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoko","family":"Fujii","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,2,26]]},"reference":[{"issue":"6","key":"3506_CR1","doi-asserted-by":"publisher","first-page":"988","DOI":"10.1093\/ndt\/gfv069","volume":"30","author":"M Iwagami","year":"2015","unstructured":"Iwagami M, et al. Current state of continuous renal replacement therapy for acute kidney injury in Japanese intensive care units in 2011: analysis of a national administrative database. Nephrol Dial Transpl. 2015;30(6):988\u201395.","journal-title":"Nephrol Dial Transpl"},{"issue":"4","key":"3506_CR2","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1007\/s00134-003-1672-8","volume":"29","author":"S Uchino","year":"2003","unstructured":"Uchino S, et al. Continuous is not continuous: the incidence and impact of circuit down-time on uraemic control during continuous veno-venous haemofiltration. Intensive Care Med. 2003;29(4):575\u20138.","journal-title":"Intensive Care Med"},{"issue":"1","key":"3506_CR3","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1038\/kisup.2011.35","volume":"2","author":"Kidney Disease: Improving Global Ou","year":"2012","unstructured":"Kidney Disease: Improving Global Outcomes Acute Kidney Injury Work Group. 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