Anaphylactoid Reaction Induced by Nafamostat Mesilate in a Hemodialysis Patient

Maruyama, Haruhiko; Miyakawa, Yoshikazu; Gejyo, Fumitake; Arakawa, Masaaki

doi:10.1159/000189371

Cited by 36 publications

(30 citation statements)

References 2 publications

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“…Small observational trials in chronic dialysis patients with increased bleeding risk suggest a reduced bleeding incidence [89-91]. Concerns with nafamostat include the absence of an antidote, and side effects such as anaphylaxis, hyperkalemia, and bone marrow suppression [92-94]. …”

Section: Recommendations and Rationalementioning

confidence: 99%

Contrast-induced acute kidney injury and renal support for acute kidney injury: a KDIGO summary (Part 2)

2013

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Acute kidney injury (AKI) is a common and serious problem affecting millions and causing death and disability for many. In 2012, Kidney Disease: Improving Global Outcomes completed the first ever international multidisciplinary clinical practice guideline for AKI. The guideline is based on evidence review and appraisal, and covers AKI definition, risk assessment, evaluation, prevention, and treatment. Two topics, contrast-induced AKI and management of renal replacement therapy, deserve special attention because of the frequency in which they are encountered and the availability of evidence. Recommendations are based on systematic reviews of relevant trials. Appraisal of the quality of the evidence and the strength of recommendations followed the Grading of Recommendations Assessment, Development and Evaluation approach. Limitations of the evidence are discussed and a detailed rationale for each recommendation is provided. This review is an abridged version of the guideline and provides additional rationale and commentary for those recommendation statements that most directly impact the practice of critical care.

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Section: Recommendations and Rationalementioning

confidence: 99%

Contrast-induced acute kidney injury and renal support for acute kidney injury: a KDIGO summary (Part 2)

2013

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“…The symptoms were anorexia, general lassitude, slight myalgia, and arthralgia and disappeared promptly after cessation of nafamostat mesilate. Severe adverse effects such as eosinophilia [3,4], agranulocytosis [4], and anaphylactoid reactions [4][5][6] were also reported. The patients in the previous reports developed anaphylactoid reactions at the first [6], the second [5], and the third use of nafamostat mesilate [4].…”

mentioning

confidence: 99%

Anaphylactoid Reaction Induced by a Protease Inhibitor, Nafamostat Mesilate, following Nine Administrations in a Hemodialysis Patient

Higuchi¹,

Yamazaki²,

Kikuchi³

et al. 2000

Nephron

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“…Various causes of anaphylactoid reactions during HD have been reported [2], including reaction to the ETO gas used to sterilize dialyzers [5], overproduction of bradykinin under treatment with ACEIs [6,7], allergy to anticoagulants [8][9][10], endotoxin contamination of dialysate [11], and bio-incompatibility with the dialysis membrane generating anaphylatoxins such as C 3 a and C 5 a [12].…”

Section: Discussionmentioning

confidence: 99%

A case of anaphylactoid reaction to acetate in acetate-containing bicarbonate dialysate

et al. 2014

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A 35-year-old man with end-stage kidney disease due to chronic glomerulonephritis was admitted to our hospital to start maintenance hemodialysis (HD). One hour after starting the first session of HD, he experienced general pruritus, urticaria, and dyspnea. Signs and symptoms were resolved by discontinuing HD and administrating an antihistamine drug; HD-associated anaphylactoid reactions were therefore suspected. Over the next few HD sessions, we changed the dialysis membrane, anticoagulant, HD circuit and needle, in that order, but general pruritus and urticaria again appeared within 3 h after starting each session of HD. Finally, when we changed the dialysate from acetate-containing bicarbonate dialysate to acetatefree bicarbonate dialysate, urticaria was clearly less than that seen in previous HD sessions, and subsided after discontinuation of HD. Subsequently, 20 mg of oral prednisolone (PSL) was administered 1 h before starting HD, and the patient did not experience general pruritus, urticaria, or dyspnea after starting the session. When administered acetate-containing bicarbonate dialysate after oral PSL pretreatment, the patient again experienced general pruritus, urticaria and dyspnea. Few reports have been published on the occurrence of anaphylactoid reactions during HD using acetate dialysate. We report a rare case of anaphylactoid reactions with acetate in acetate-containing bicarbonate dialysate that were reduced with the use of acetatefree bicarbonate dialysate and oral PSL pretreatment.

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Anaphylactoid Reaction Induced by Nafamostat Mesilate in a Hemodialysis Patient

Cited by 36 publications

References 2 publications

Contrast-induced acute kidney injury and renal support for acute kidney injury: a KDIGO summary (Part 2)

Contrast-induced acute kidney injury and renal support for acute kidney injury: a KDIGO summary (Part 2)

Anaphylactoid Reaction Induced by a Protease Inhibitor, Nafamostat Mesilate, following Nine Administrations in a Hemodialysis Patient

A case of anaphylactoid reaction to acetate in acetate-containing bicarbonate dialysate

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