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Previous Volume 332:687 March 9, 1995 Number 10 Next

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To the Editor: Nafamostat mesylate (6-amidino-2-naphthyl p-guanidinobenzoate, dimethanesulfonate; molecular weight, 540) is a synthetic serine protease inhibitor that is widely used to treat acute pancreatitis in Japan.¹ The drug and its metabolites reversibly inhibit amiloride-sensitive sodium conductance of renal cortical collecting ducts,^2,3 thus impairing urinary potassium excretion. Hyperkalemia could therefore develop in patients receiving this drug.

We describe a 77-year-old man admitted to the hospital for acute pancreatitis in whom nafamostat mesylate therapy was associated with hyperkalemia. The patient was initially treated with intravenous fluids and a continuous infusion of nafamostat mesylate (150 mg per day). The intravenous fluid . . . [Full Text of this Article]

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