Nafamostat mesilate as anticoagulant for blood purification: a systematic review and meta-analysis
Authors' conclusion
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.
Study context
- Population
- Patients undergoing blood purification (RRT or ECMO)
- Participants
- 4,349 patients · 16 studies
- Comparison
- Nafamostat mesilate (NM) vs conventional anticoagulants (unfractionated heparin, low-molecular-weight heparin, regional citrate) or non-anticoagulant (NA) during blood purification
- Outcome
- Bleeding, filter life and mortality
Methodological detailssubgroup analysis, sensitivity analysis, publication bias analysis
- Subgroup analysis
- Sensitivity analysis
- Publication bias analysis
Pooled result
As reported in the abstract
Relative risk (95% CI)P value
NM vs Conventional anticoagulantsbleeding
0.53(0.29–0.97)
P = 0.040NM vs NAbleeding complication
0.49(0.18–1.35)
P = 0.170NM vs NAin-hospital mortality
0.87(0.77–0.97)
P = 0.015MD, h (95% CI)P value
NM vs Conventional anticoagulantsfilter life
−1.23(−4.27-1.81)
P = 0.428NM vs NAfilter life
4.84(0.18–9.51)
P = 0.042Original publication
Nafamostat mesilate as anticoagulant for blood purification: a systematic review and meta-analysis. Crit Care. Published 24 December 2025. doi:10.
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