Zhan Xiaofeng, Qu Xiaolei, Wu Di, Wang Guangpu, Bai Shoujun, Ji Tingting
Department of Nephrology, Qingpu Branch of Zhongshan Hospital Affiliated to Fudan University, Shanghai 201700, China.
Iran J Kidney Dis. 2025 Feb 25;19(1):41-49. doi: 10.52547/5j9v7385.
To investigate the effect of continuous renal replacement therapy (CRRT) in patients with severe acute kidney injury (AKI) by using Nafamostat Mesilate (NM).
Eighty patients with AKI who underwent CRRT from March 2022 to January 2022 were divided into control group (n = 40, treated with unfractionated heparin) and Observation group (n = 40, treated with NM). The duration of the first filter use, the number of filters used 72 hours after treatment, coagulation and renal functions, adverse reactions, bleeding events, length of stay in intensive care unit (ICU) and survival status at 28 days were compared between the two groups.
The observation group used the first filter for a longer period of time than the control group, and after 72 hours of treatment, the number of filters used was less than that of the control group (P < .05); Compared with before treatment, the levels of fibrinogen (FIB) and platelet count (PLT) in the observation group and control group decreased after 48 hours of treatment, while the levels of activated partial thromboplastin time (APTT), prothrombin time (PT), thrombin time (TT), and international normalized ratio (INR) increased. However, the levels of FIB and PLT in the former group were higher, while the levels of APTT, PT, TT, and INR were lower (P < .05); Compared with before treatment, the levels of creatinine (Scr), urea nitrogen (BUN), and serum cystatin C (CysC) in the observation group and control group decreased after 48 hours of treatment, and the former was even lower (P < .05); the incidence of bleeding events in the observation group was lower than that in the control group, the length of stay in ICU was shorter than that in the control group, and finally the 28-day survival rate was higher than that in the control group (P < .05). The adverse reactions of the two groups were similar (P > .05).
NM can improve the coagulation function and renal function in patients with severe AKI undergoing CRRT, prolong the duration of the filter use, reduce the number of filters used, shorten the length of ICU stay, reduce the incidence of bleeding events, and improve the prognosis.
探讨甲磺酸萘莫司他（NM）在连续性肾脏替代治疗（CRRT）中对重症急性肾损伤（AKI）患者的影响。
选取2022年3月至2022年1月期间接受CRRT治疗的80例AKI患者，分为对照组（n = 40，接受普通肝素治疗）和观察组（n = 40，接受NM治疗）。比较两组首次滤器使用时长、治疗72小时后滤器使用数量、凝血功能及肾功能、不良反应、出血事件、重症监护病房（ICU）住院时长以及28天生存状况。
观察组首次滤器使用时间长于对照组，治疗72小时后滤器使用数量少于对照组（P <.05）；与治疗前相比，观察组和对照组治疗48小时后纤维蛋白原（FIB）及血小板计数（PLT）水平降低，活化部分凝血活酶时间（APTT）、凝血酶原时间（PT）、凝血酶时间（TT）及国际标准化比值（INR）升高。然而，观察组FIB及PLT水平更高，而APTT、PT、TT及INR水平更低（P <.05）；与治疗前相比，观察组和对照组治疗48小时后血肌酐（Scr）、尿素氮（BUN）及血清胱抑素C（CysC）水平降低，且观察组更低（P <.05）；观察组出血事件发生率低于对照组，ICU住院时长短于对照组，最终28天生存率高于对照组（P <.05）。两组不良反应相似（P >.05）。
NM可改善接受CRRT治疗的重症AKI患者的凝血功能及肾功能，延长滤器使用时长，减少滤器使用数量，缩短ICU住院时长，降低出血事件发生率，改善预后。
