nafamostat / Generic mfg. - LARVOL DELTA

EFFECT OF NAFAMOSTAT MESYLATE ON BRADYKININ PRODUCTION AND BLOOD PRESSURE STABILITY DURING LDL APHERESIS IN CHRONIC LIMB-THREATENING ISCHEMIA (ISN-WCN 2026) - "Systolic blood pressure in the HP group fell from 131 ± 4.89 mmHg at baseline to 111 ± 4.52 mmHg at 30 min (p < 0.01) and returned to 128 ± 4.86 mmHg at 120 min (p = 0.56), while the NM group remained stable (124 ± 3.95, 126 ± 3.64, 126 ± 3.82 mmHg; p = 0.15, 0.71). Limb outcomes were similar in both groups.Download: Download high-res image (253KB)Download: Download full-size imageConclusion For CLTI patients experiencing hypotension during LDL apheresis, switching from HP to NM may help stabilize blood pressure and enhance treatment tolerability by attenuating bradykinin production.I have potential conflict of interest to disclose.This study was supported in part by a grant for medical research from the Okinaka Memorial Institute for Medical Research, Tokyo, Japan.I did not use generative AI and AI-assisted technologies in the writing process."

Cardiovascular • Hypotension • Peripheral Arterial Disease

PLASMA EXCHANGE FOR ANTI-GLOMERULAR BASEMENT MEMBRANE ANTIBODY DISEASE WITH DIALYSIS DEPENDENCY: A CASE SERIES ON CLINICAL OUTCOMES AND SAFETY (ISN-WCN 2026) - "Anticoagulation was achieved with heparin or nafamostat, and PEx and hemodialysis were performed sequentially...The transient antibody rebound observed in one case underscores the limitation of relying solely on serological remission and highlights the need for flexible therapeutic adjustments. These findings emphasize the heterogeneity of this high-risk population requiring RRT and the importance of individualized treatment strategies that balance efficacy and safety."

Clinical • Clinical data • Fibrosis • Glomerulonephritis • Hematological Disorders • Immunology • Lupus Nephritis • Nephrology

INCIDENCE AND RISK FACTORS OF NEUROLOGICAL COMPLICATIONS IN PEDIATRIC CONTINUOUS KIDNEY REPLACEMENT THERAPY (ISN-WCN 2026) - "Initial anticoagulation regimens included heparin (n=46), nafamostat (n=178), and combination therapy (n=15)...Careful monitoring and preventive strategies are warranted, particularly in children with low body weight, elevated lactate at initiation, and prolonged CKRT duration.I have potential conflict of interest to disclose.This work was supported by the National Center for Child Health and Development (grant no: 2023C-32 and 2024B-4).I used generative AI and AI-assisted technologies in the writing process.During the preparation of this work the author used ChatGPT (OpenAI) in order to assist with English editing of the manuscript draft. After using this tool, the author reviewed and edited the content as needed and takes full responsibility for the content of the publication."

Clinical • Cerebral Hemorrhage • CNS Disorders • Hematological Disorders • Pediatrics

SRP14 TRIGGERS APOPTOSIS IN RENAL TUBULAR EPITHELIAL CELLS TO EXACERBATE ACUTE KIDNEY INJURY THROUGH AN INTERACTION WITH RPS7 (ISN-WCN 2026) - "Additionally, the SRP14 expression was significantly increased in the renal tubules of patients with acute tubular necrosis, as well as in four AKI mouse models following the procedures of ischemia-reperfusion injury (IRI), cecal ligation and puncture, and treatment with lipopolysaccharide and cisplatin. Given the importance of RPS7 in SRP14-regulated apoptosis, we screened an apoptosis-specific library containing 356 US Food and Drug Administration–approved compounds to identify those that inhibit RPS7. We identified nafamostat mesilate as a potent RPS7 inhibitor that attenuated renal IRI by inhibiting RPS7-associated RTEC apoptosis.Conclusion These findings suggest that SRP14 triggers apoptosis in RTECs, thereby exacerbating AKI, by interacting with RPS7, which may be a potential therapeutic target for nafamostat mesylate to slow the progression of AKI.I have potential conflict of interest to disclose.This work was supported by National Natural Science Foundation of..."

Acute Kidney Injury • Cardiovascular • Nephrology • Renal Disease • Reperfusion Injury • MDM2 • TP53

Nafamostat Mesilate as an Anticoagulation Strategy for Heparin-Induced Thrombocytopenia: A Case Report. (PubMed, J Blood Med) - "Heparin was discontinued, and anticoagulation transitioned to argatroban and later nafamostat mesilate (NM) due to argatroban shortage. Key questions remain regarding heparin rechallenge safety, causative agent identification in multi-heparin exposure, and rapid differentiation of HIT from anaphylactoid reactions. Further studies are needed to optimize HIT management in high-risk populations."

Journal • Cardiovascular • Chronic Kidney Disease • Hematological Disorders • Nephrology • Renal Disease • Thrombocytopenia

Combined medical and endovascular therapy for disseminated intravascular coagulation caused by distal stent graft-induced new entry following thoracic endovascular aortic repair. (PubMed, Indian J Thorac Cardiovasc Surg) - "Intravenous nafamostat mesylate was administered, resulting in temporary stabilization...The patient was discharged on postoperative day 40 and remained clinically stable with no recurrence of DIC at 1 year of follow-up. This case highlights the potential usefulness of a combined medical and endovascular approach for managing DIC associated with distal SINE following TEVAR."

Journal • Cardiovascular • Colonic Polyps • Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Thrombocytopenia

Comparison of Anticoagulant Effects of Different Doses of Nafamostat in Continuous Renal Replacement Therapy (CRRT) in the Intensive Care Unit (ICU) (clinicaltrials.gov) - P2 | N=92 | Not yet recruiting | Sponsor: Zhujiang Hospital

New P2 trial • Critical care

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. (PubMed, Front Med (Lausanne)) - "But because of poor evidence, the conclusions must be interpreted with caution. https://www.crd.york.ac.uk/prospero/, identifier CRD420251077749."

Journal • Retrospective data • Review • Acute Kidney Injury • Nephrology • Renal Disease

High-Throughput Screening of FDA-Approved Drugs for Antibacterial and Antibiofilm Activities Against Multidrug-resistant Pseudomonas aeruginosa. (PubMed, ACS Omega) - "By using a systematic screening-prioritization-safety filtering framework, this study identified rifabutin and nafamostat as prioritized repurposing candidates against MDR P. aeruginosa , highlighting the importance of early safety evaluation in antimicrobial drug repurposing."

FDA event • Journal • Hematological Disorders

Safety and effectiveness of nafamostat mesylate in continuous renal replacement therapy in patients with sepsis-associated acute kidney injury: a prospective randomized controlled trial. (PubMed, Open Med (Wars)) - "The lifespans of the first filter were 60.2 ± 10.09 and 59.07 ± 11.44 h, and the ICU lengths were 7.35 ± 1.35 and 7.21 ± 1.17 days, Nafamostat mesylate prolonged filter lifespan compared to RCA, however, ICU LOS was same. The anticoagulation regimen of nafamostat mesylate may be safe and effective in patients with sepsis-associated AKI receiving CRRT."

Journal • Acute Kidney Injury • Critical care • Infectious Disease • Nephrology • Renal Disease • Septic Shock

Spontaneous Perirenal Hemorrhage Mimicking Renal Rupture in a Long-Term Hemodialysis Patient: A Case Report. (PubMed, Clin Case Rep) - "Postoperatively, dialysis anticoagulation was temporarily switched to nafamostat mesylate and later safely resumed with low-molecular-weight heparin; at approximately 7 months after surgery, hemoglobin was 109 g/L with no recurrence. This case underscores the limits of CT specificity in large hematomas, the need to consider extracapsular bleeding when embolization fails, the role of pathology for definitive diagnosis, and the importance of early surgical exploration and individualized anticoagulation in hemodialysis patients."

Journal • Cardiovascular • Hematological Disorders • Nephrology • Oncology • Pain • Renal Disease • Vasculitis

Anticoagulation approaches in hemodialysis: a systematic review of efficacy, safety, and literature gap. (PubMed, Int Urol Nephrol) - "Anticoagulant selection in HD should balance efficacy, safety, cost, administration, and monitoring, tailored to patient risk profiles and institutional resources. Future research should prioritize head-to-head comparisons, long term outcomes, cost effectiveness, and the effects of anticoagulation strategies on dialysis adequacy to support more precise clinical decision making."

Journal • Cardiovascular

Clinical study of serine protease inhibitors in high-risk bleeding patients undergoing maintenance hemodialysis (ChiCTR) - P=N/A | N=60 | Recruiting | Sponsor: The peoples hospital of xuancheng city; The peoples hospital of xuancheng city

New trial • Chronic Kidney Disease • Nephrology • Renal Disease

A Randomized, Active-Controlled, Open-Label Clinical Study of Nafamostat Mesylate for Reducing Bleeding Risk in Maintenance Hemodialysis Patients at High Risk of Bleeding (ChiCTR) - P=N/A | N=338 | Not yet recruiting | Sponsor: The Seventh Affiliated Hospital Sun Yat-sen University; The Seventh Affiliated Hospital of Sun Yat-sen University

New trial • Renal Disease

Comparison of Anticoagulant Effects Between Nafamostat Mesylate and Sodium Citrate in Double Filtration Plasmapheresis (ChiCTR) - P=N/A | N=140 | Not yet recruiting | Sponsor: The First Affiliated Hospital of Army Medical University PLA; The First Affiliated Hospital of Army Medical University PLA

New trial • ANCA Vasculitis • Chronic Kidney Disease • Glomerulonephritis • Immunology • Inflammatory Arthritis • Lupus • Lupus Nephritis • Nephrology • Renal Disease • Transplantation • Vasculitis

Variations in the expression and function of SARS-CoV-2 entry molecules induced by exposure to nano- and microparticles. (PubMed, Environ Int) - "Furthermore, we found that serine protease inhibitors such as nafamostat can regulate TMPRSS2 activity promoted by PM exposure. Our results provide experimental evidence that exposure to PM with specific properties may enhance intracellular entry of SARS-CoV-2."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases • TMPRSS2

Dose response of nafamostat mesylate for anticoagulation monitoring in pediatric critical care during continuous venovenous hemodiafiltration. (PubMed, Sci Rep) - "These findings indicate that aPTT may be a more sensitive and reliable parameter than ACT for monitoring NM's anticoagulant effects in pediatric CVVHDF. The results challenge current ACT-based monitoring practices and highlight the need for prospective validation to refine anticoagulation strategies using NM in critically ill children."

Journal • Retrospective data • Critical care • Pediatrics

Nafamostat mesilate as anticoagulant for blood purification: a systematic review and meta-analysis. (PubMed, Crit Care) - "NM is a safe and effective anticoagulant for blood purification, showing lower bleeding risk than conventional anticoagulants and longer filter life than NA, which is particularly suitable for patients at high risk of bleeding."

Journal • Retrospective data • Review

Nafamostat Mesylate Protects Against Acute Renal Ischemia-Reperfusion Injury by Alleviating Mitochondrial Dysfunction, Inhibiting Ferroptosis, and Regulating Proximal Tubular Cells: A Multi-Omics Analysis. (PubMed, Ther Apher Dial) - "NM protects against AKI by reducing reactive oxygen species, upregulating fatty acids, and regulating ferroptosis signaling pathways in proximal tubular cells."

Journal • Acute Kidney Injury • Cardiovascular • Inflammation • Metabolic Disorders • Nephrology • Renal Disease • Reperfusion Injury

Critical role of the mast cell/tryptase/PAR2 axis in anastrozole-induced pain. (PubMed, Br J Pharmacol) - "Our results provide a new mechanism underlying anastrozole-induced pain, highlighting the mast cell/tryptase/PAR2 axis as a therapeutic target to manage painful symptoms."

Journal • Breast Cancer • Hormone Receptor Breast Cancer • Hormone Receptor Positive Breast Cancer • Musculoskeletal Diseases • Musculoskeletal Pain • Oncology • Pain • Solid Tumor

Effect of extracorporeal anticoagulation with nafamostat mesilate and continuous renal replacement therapy on sepsis complicated with acute kidney injury. (PubMed, Int J Clin Pharmacol Ther) - "NM outperforms RCA in prolonging the hemofilter lifespan, reducing hemofilter replacement frequency, improving renal perfusion and renal function, and eliminating inflammatory mediators."

Journal • Acute Kidney Injury • Infectious Disease • Nephrology • Oncology • Renal Disease • Septic Shock • CST3 • IL6 • TNFA

Successful application of innovative hybrid anticoagulation in continuous renal replacement therapy for an ultra-elderly patient: a case report. (PubMed, BMC Nephrol) - "The innovative hybrid anticoagulation strategy effectively prolonged CRRT circuit longevity in an ultra-elderly patient at high risk of citrate accumulation without procedure-associated complications. This approach represents a promising alternative for patients who have contraindications to conventional citrate anticoagulation."

Journal • Acute Kidney Injury • Cardiovascular • Congestive Heart Failure • Heart Failure • Hematological Disorders • Hepatology • Liver Failure • Metabolic Disorders • Nephrology • Renal Disease • Respiratory Diseases

Searching for Novel Antiviral Agents as COVID19 Treatments: Guanidino Diaryl Thioureas. (PubMed, ChemMedChem) - "The findings suggest that reversible inhibitors may be suboptimal for TMPRSS2 targeting, as camostat and nafamostat exert their effects through irreversible covalent binding. Future efforts should focus on developing irreversible TMPRSS2 inhibitors to enhance antiviral efficacy against SARS-CoV-2."

Journal • Infectious Disease • Novel Coronavirus Disease • Respiratory Diseases

Nafamostat mesylate in renal replacement therapy: balancing efficacy with emerging risks of hyperkalemia. (PubMed, Ren Fail) - No abstract available

Journal

Multifaceted anticancer activity of nafamostat mesylate in human fibrosarcoma: first evidence of mitochondrial apoptosis and suppressed MMP-2/-9 mRNA expression. (PubMed, BMC Pharmacol Toxicol) - "This study provides the first evidence that nafamostat mesylate exerts multifaceted anticancer effects in HT1080 fibrosarcoma cells, targeting proliferation, migration, apoptosis, and invasion. These findings support the potential repurposing of nafamostat mesylate as a therapeutic agent for fibrosarcoma and warrant further preclinical investigations to evaluate its translational applicability."

Journal • Fibrosarcoma • Oncology • Sarcoma • Solid Tumor • ANXA5 • MMP2 • MMP9