Nephrisol-D is a specialized nutrition formulated to meet the requirements for those with renal insufficiency in dialysis stage, to replenish protein loss during dialysis and prevent malnutrition.
Nephrisol-D contains :
- High protein amount
- Completed with 9 essentials amino acids (High Biological Value Protein)
- Completed with 9 vitamins and 6 minerals
- Lactose free
Feature Benefit
| FEATURE | BENEFIT |
| Formula is designed for Dialysis | Not only fulfill daily nutrition need, but also suit for patient’s medical condition. |
| High protein | Replenish protein lost during dialysis |
| High Biological Value Protein with 9 essential amino acids | To improve albumin level |
| Mineral adjusted for CKD (Dialysis) condition | Prevent adverse event due to unproper micronutrient consumption. |
| Maltodextrin as carbohydrate source | Easily dissolved & absorbed (no hot water), mask the fishy taste of fat and the bitter taste of protein |
| Combine whey and casein | Creating faster and longer protein synthesis. |
| Non animal fat | Rich in MUFA and PUFA, MCT, and also the content of USFA (twice higher) than SFA. |
| Sucralose as sweetener | Does not affect blood sugar levels, carbohydrate metabolism or insulin production. |
| Density 1.04 | Can be given through NGT/Sonde/tube feeding. |
| Low Osmolality | to prevent adverse event (diarrhea) |
Precaution : Not suitable to those with renal insufficiency which is not in dialysis stage (predialysis).
References :
1.Eustace JA, Coresh J, Kutchey C, Te PL, Gimenez LF, Scheel PJ, et.al. Randomized double-blind trial of oral essential amino acids for dialysis-associated hypoalbuminemia. [Internet]. [cited 2021 April 16th]. Available from: https://core.ac.uk/reader/82189560
2.Fouque D and Mitch WE, 2012. Dietary Approaches to Kidney Disease. In: Taal MW, Chertow GM, Mars PA, Skorecki K, Yu AS and Brenner BM. Editors. Brenner & Rector’s The Kidney. 9th ed. USA; Elsiver Saunders. 2170-204.
3.Goldstein-Fuchs, D, LaPierre AM. 2014. Nutrition and Kidney Disease. In: Gilbert GJ, Weiner ME. Editors. National Kidney Foundation’s Primer on Kidney Diseases. Philadelphia; Elseiver Saunderz. P:467-74.
4.Ikizler TA, Burrowes JD, Byham-Gray LD, Campbell KL, Carrero JJ, Chan W, et.al. KDOQI Clinical Practice Guideline for Nutrition in CKD: 2020 Update. [Internet]. [cited 2021 April 16th]. Available from: https://www.ajkd.org/article/S0272-6386(20)30726-5/fulltext
5.NEPHRISOL-D[Product Information] Jakarta. Indonesia. PT Kalbe Farma Tbk; 2017
6.Wolfson N. Management of Protein and Energy Intake in Dialysis Patients. JASN 1999, 10 (10) 2244-2247
Preparation
Nephrisol-D can be taken orally or administered via a nasogastric tube.
- Oral feeding: To prepare a 250 ml feeding, gradually add 4 level scoops of Nephrisol-D (+ 61 gram) into a 200 ml warmed water and mix until dissolve. Other alternative, Nephrisol-D can be served like snack, smoothie, pudding, etc. It’s not advisable to cook or boil in high temperature (above 600 Celsius) as it may denature protein content of Nephrisol-D. Consume Nephrisol-D in between meals.
- Tube feeding: Follow physician’s instructor.
- Not intended to be used for parenteral administration
Nutrition Fact
1.04 kcal/mL nutritionally complete nutritional drink, with 9 essential amino acids, 7 non-essential amino acids, 9 vitamins, and 6 minerals
| NUTRITION | UNIT | PER SERVING | % DV |
| Calories | kCal | 260 | |
| Calories from fat | kCal | 50 | |
| Total Fat | g | 6 | 10% |
| Trans fat | g | 0 | |
| Saturated fat | g | 1.5 | 9% |
| Cholesterol | mg | 10 | |
| Protein | g | 13 | 21% |
| Total Carbohydrates | g | 39 | 13% |
| Sucrose | g | 5 | |
| Lactose | g | 0 | |
| Dietary fiber | g | 0 | |
| Vitamins | |||
| Vitamin A | IU | 250 | 15% |
| Vitamin C | mg | 10 | 10% |
| Vitamin E | mg | 1.68 | 10% |
| Vitamin B1 | mg | 0.23 | 25% |
| Vitamin B2 | mg | 0.28 | 25% |
| Niacin | mg | 3.2 | 20% |
| Vitamin B6 | mg | 0.37 | 30% |
| Folic acid | μg | 67 | 15% |
| Pantothenic acid | mg | 1 | 15% |
| Minerals | |||
| Sodium | mg | 75 | 3% |
| Potassium | mg | 55 | 1% |
| Calcium | mg | 183 | 25% |
| Phosphorus | mg | 85 | 15% |
| Zinc | mg | 4 | 10% |
| Selenium | μg | 5 | 15% |
| Total N (protein & amino acids) | g | 2 | |
| Essential Amino Acids | |||
| Leucine | g | 1.43 | |
| Isoleucine | g | 1.06 | |
| Valine | g | 0.99 | |
| Tryptophan | g | 0.19 | |
| Phenylalanine | g | 0.79 | |
| Methionine | g | 0.81 | |
| Threonine | g | 0.73 | |
| Lysine | g | 1 | |
| Histidine | g | 0.43 | |
| Non Essential Amino Acids | |||
| Aspartic acid | g | 0.9 | |
| Glutamic acid | g | 2.28 | |
| Serine | g | 0.53 | |
| Glysine | g | 0.17 | |
| Arginine | g | 0.41 | |
| Alanine | g | 0.56 | |
| Tyrosine | g | 0.35 | |
Ingredients
Maltodextrin, Vegetable Oil (Canola, Sunflower, Palm Kernel and Coconut Oil), Whey Protein, Amino Acids, Calcium Caseinate, Sucrose, Minerals (Calcium Carbonate, Monosodium Phosphate, Sodium Chloride, Magnesium Oxide, Zinc Oxide, Sodium Selenite), Artificial Vanilla Flavor, Natural Identical Milk Flavor, Vitamins (L Sodium Ascorbate, Vitamin E, Nicotinamide, Calcium Pantothenate, Vitamin A, Pyridoxine HCl, Vitamin D3, Cyanocobalamin, Thiamine HCl, Riboflavin, Folic Acid, Biotin), Sweetener Sucralose 22 mg/serving
Storage
Opened package should be stored tightly in a cool, dry, and clean place. Consume within 1 month of opening.
Packaging & Flavor
1 box contain 185 gram nutrition powder with Vanilla flavor.
1 box available for 3 servings.
FAQ
If as a substitute food, NEPHRISOL - D can be given up to 6 times / day or adjusted to the needs and patient’s conditions. If as a complementary food can be given 2-3 times / day.
NEPHRISOL - D osmolality is 367 mOsm / kg for vanilla variants
Prepare 200 mL of warm boiled water with a temperature of <70 degrees Celsius then mix and stir until it is mixed homogeneously. Do not use hot water because it can damage the protein content.
NEPHRISOL - D if as a substitute food can be given up to 6 times / day or adjusted to the needs and conditions of the patient. If as a complementary meal can be given as much as 1-3 times / day.
Yes it’s allowed. Our product as complementary nutrition, that’s why the calorie is not high. It will be easier to adjust and patient can still eat their daily meals. Moreover we have amino acids premix which’s complying to the EAA: NEAA ratio following the guideline and is needed by patient, it is high biological value protein, an essential for every metabolic process, as main component to rebuild and maintain the balance of body functions, meanwhile other products don’t describe it. If we put more than 4 spoons per serving, we need to add the water volume so we can maintain the density does not exceed than 1.5 kcal/mL
The same with oral preparations depends on how many calorie patient needs. It can be accepted for the tube feeding size: 16 – 18 gauge and put each scoops gradually (while stirring and mix until dissolve to avoid the granules) and make sure that the density does not exceed than 1.5 kcal/mL
DM patients who are given NEPHRISOL - D to always monitor their blood sugar levels in order to stay controlled. Sometimes it is necessary to adjust the dose or adjust the type of diabetes medication so that the fulfillment of nutrition in DM patients is met.
NEPHRISOL - D contains a combination of whey protein (concentrate and isolate) and casein. Whey protein is fast digesting protein, so it is quickly used for protein synthesis. Casein is a slow digesting protein, which has the advantage of being able to last longer so that it can take over protein synthesis in the body when whey protein levels have started to fall. The combination of these has benefit in creating faster and longer protein synthesis.
NEPHRISOL - D can be given to diabetes patients whose glucose levels have been controlled. The calorie concentration is not categorized as high, which is 1 kcal/mL. After NEPHRISOL - D is given, as it is with nutritional therapy in general, glucose levels should be monitored accordingly.
