Scholarlink

Background <p>Nafamostat mesylate, an anticoagulant with a short half-life, is useful during hemodialysis for patients at high risk of bleeding. Research on the appropriate dosage of nafamostat has been insufficient. This study aimed to investigate the optimal dosage of nafamostat using a dosage prediction model.</p> Methods <p>We retrospectively analyzed medical records from 12 centers affiliated with Yeolin Medical Foundation over an 8-month period. Candidate predictor variables were evaluated using bootstrapping and stepwise regression to determine feature importance. Predictive models were compared based on performance metrics.</p> Results <p>In total, 308 sessions from 88 patients without dialyzer clotting were selected. The average nafamostat dose was 21.90 ± 6.82&#xa0;mg/h. The top four important features were oral anticoagulant use, dry body weight, age, and hemoglobin level. The best-performing model using 12 variables showed a root mean squared error of 4.11&#xa0;mg/h and an adjusted R² value of 0.49. Multivariable linear regression showed that oral anticoagulant use (coefficient − 14.20, 95% confidence interval [CI] -18.28 to -10.12, <i>P</i> &lt; 0.001) and age (-0.13, 95% CI -0.19 to -0.08, <i>P</i> &lt; 0.001) were associated with a lower nafamostat dose, whereas dry body weight (coefficient 0.15, 95% CI 0.09 to 0.22, <i>P</i> &lt; 0.001) and hemoglobin level (1.13, 95% CI 0.51 to 1.76, <i>P</i> &lt; 0.001) were associated with a higher dose.</p> Conclusion <p>The nafamostat dosage prediction model can be used to calculate the dose required for individual patients. However, further studies for model improvement and external validation are required.</p> Clinical trial number <p>Not applicable.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

Development of a predictive model for nafamostat mesylate dosing in hemodialysis

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2025年10月16日

查看全文
  • Shin Yeong Lee,
  • Jin Sug Kim,
  • Hwa Jeong Kim,
  • Jeong Min Yoon,
  • Moon Jeong Seo,
  • Ji Yung Lee,
  • Kyung-A Choi,
  • Kyun Sang Lee,
  • Ah Ran Choi,
  • Sung Min Ko,
  • Kyoung Hwa Seo,
  • Hae Rim Kim

摘要

Background

Nafamostat mesylate, an anticoagulant with a short half-life, is useful during hemodialysis for patients at high risk of bleeding. Research on the appropriate dosage of nafamostat has been insufficient. This study aimed to investigate the optimal dosage of nafamostat using a dosage prediction model.

Methods

We retrospectively analyzed medical records from 12 centers affiliated with Yeolin Medical Foundation over an 8-month period. Candidate predictor variables were evaluated using bootstrapping and stepwise regression to determine feature importance. Predictive models were compared based on performance metrics.

Results

In total, 308 sessions from 88 patients without dialyzer clotting were selected. The average nafamostat dose was 21.90 ± 6.82 mg/h. The top four important features were oral anticoagulant use, dry body weight, age, and hemoglobin level. The best-performing model using 12 variables showed a root mean squared error of 4.11 mg/h and an adjusted R² value of 0.49. Multivariable linear regression showed that oral anticoagulant use (coefficient − 14.20, 95% confidence interval [CI] -18.28 to -10.12, P < 0.001) and age (-0.13, 95% CI -0.19 to -0.08, P < 0.001) were associated with a lower nafamostat dose, whereas dry body weight (coefficient 0.15, 95% CI 0.09 to 0.22, P < 0.001) and hemoglobin level (1.13, 95% CI 0.51 to 1.76, P < 0.001) were associated with a higher dose.

Conclusion

The nafamostat dosage prediction model can be used to calculate the dose required for individual patients. However, further studies for model improvement and external validation are required.

Clinical trial number

Not applicable.