Hyperkalemia Due to Nafamostat Mesylate

Abstract
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.