Efficacy and safety of nafamostat mesylate versus heparin anticoagulation in adult kidney disease patients using continuous renal replacement therapy: a systematic review and meta-analysis

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Source: Frontiers Medicine

Original: https://www.frontiersin.org/articles/10.3389/fmed.2026.1713412...

Published: 2026-02-17T00:00:00Z

The study compared the safety and efficacy of nafamostat mesylate (NM) and heparin as anticoagulants in continuous renal replacement therapy in adult patients with acute kidney injury[5]. An analysis of seven retrospective cohort studies showed no significant differences between the two groups in filter life or anticoagulant efficacy[5]. The risk of bleeding events was similar in both groups[5]. In patients with NM, the duration of hospitalization was significantly reduced by an average of 3.43 days compared to heparin[5]. NM caused a greater reduction in thrombin time than heparin, while no significant differences were found in other coagulation parameters (APTT and INR)[5]. The conclusion of the study states that NM shows similar safety and efficacy to heparin in continuous renal replacement therapy, while it may reduce hospital stay[5]. However, the authors emphasize that the conclusions should be interpreted with caution due to the poor quality of the available evidence[5].