caa a22 4500 47705675X CHVBK 20180405111348.0 cr unu---uuuuu 170330e19961001xx s 000 0 eng 10.1007/s002280050176 doi (NATIONALLICENCE)springer-10.1007/s002280050176 Additional mechanisms of nafamostat mesilate-associated hyperkalaemia [Elektronische Daten] [S. Ookawara, K. Tabei, T. Sakurai, Y. Sakairi, H. Furuya, Y. Asano] Objective: Nafamostat mesilate, a potent protease inhibitor, is widely used for the treatment of pancreatitis, disseminated intravascular coagulation and as an anticoagulant in haemodialysis. However, hyperkalaemia associated with nafamostat mesilate has been reported. It is thought to be due to decreased urinary potassium excretion, of the drug suppression of aldosterone secretion, and a direct inhibitory action on the apical Na+ conductance in collecting ducts. We have seen two cases of nafamostat mesilate associated-hyperkalaemia, which indicated that extrarenal potassium imbalance might play a role in inducing hyperkalaemia. Methods: To examine the effect of nafamostat mesilate on potassium transport in erythrocytes in vitro, 86RbCl uptake was measured in red blood cells from eight healthy volunteers. Results: Nafamostat mesilate and a metabolite, 6-amidino-2-naphthol, at concentrations of 10−4 and 10−3 M, respectively, significantly, suppressed potassium influx whilst another metabolite, p-guanidinobenzoic acid, had no effect. The inhibitory action of nafamostat mesilate was not affected by various inhibitors. Conclusion: Nafamostat mesilate and its metabolite, 6-amidino-2-naphthol, suppressed potassium influx in erythrocytes by inhibition of a Na-K ATPase dependent pathway, which was not inhibited by amiloride, barium, nor by frusemide (furosemide). Springer-Verlag Berlin Heidelberg, 1996 Key words Nafamostat mesilate nationallicence Haemodialysis nationallicence anticoagulant nationallicence hyperkalaemia nationallicence erythrocyte nationallicence potassium nationallicence 6-amidino-2-naphthol nationallicence p-guanidinobenzoic acid nationallicence Ookawara S. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut Tabei K. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut Sakurai T. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut Sakairi Y. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut Furuya H. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut Asano Y. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut https://doi.org/10.1007/s002280050176 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s002280050176 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Ookawara S. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut NATIONALLICENCE 700 1- Tabei K. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut NATIONALLICENCE 700 1- Sakurai T. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut NATIONALLICENCE 700 1- Sakairi Y. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut NATIONALLICENCE 700 1- Furuya H. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut NATIONALLICENCE 700 1- Asano Y. Division of Nephrology, Department of Medicine, Jichi Medical School, 3311-1 Minamikawachi-machi, Kawachi-gun, Tochigi-ken, 329-04, Japan, JP aut Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer