Nafamostat mesilate is not appropriate as an anticoagulant during continuous renal replacement therapy in dogs

We performed continuous renal replacement therapy (CRRT) in clinically healthy dogs (n=7) to evaluate the utility of nafamostat mesilate (NM) as an anticoagulant. In 3 of the 7 dogs, CRRT had to be discontinued before the target duration due to coagulation in the extracorporeal circuit, into which NM was administered constantly at the rate of 2.0-6.0 mg/kg per hour. The rate of administration of NM was greater than the recommended dose of NM in humans. Further, all the dogs suffered vomiting during CRRT with NM infusion. We therefore recommend that NM is not used as an anticoagulant during CRRT in dogs.