Nephrisol-D Nephrisol-D
Product
Product Nephrisol-D
Product

Nephrisol-D là công thức dinh dưỡng đặc biệt nhằm đáp ứng nhu cầu cho những đối tượng bị suy thận trong giai đoạn cần lọc máu, nhằm mục đích bổ sung lượng protein bị mất trong quá trình lọc máu và ngăn ngừa suy dinh dưỡng. 

Nephrisol-D bao gồm:

  1. Lượng protein cao
  2. Công thức toàn diện với 9 loại acid amin thiết yếu (protein có giá trị sinh học cao) 
  3. 9 loại vitamin và khoáng chất
  4. Không chứa lactose 

Brands Info

TÍNH NĂNG VÀ LỢI ÍCH

 

ĐẶC TÍNH LỢI ÍCH 
Công thức được thiết kế cho các đối tượng lọc máu Không chỉ đáp ứng nhu cầu dinh dưỡng hàng ngày mà còn phù hợp với tình trạng bệnh của bệnh nhân.
Lượng protein  Bổ sung lượng protein bị thiếu hụt trong suốt giai đoạn lọc máu. 
Protein có giá trị sinh học cao với 9 Axit amin thiết yếu Để cải thiện mức độ Albumin và tỷ lệ sống sót
Các loại khoáng chất được điều chỉnh cho đối tượng mắc bệnh thận mạn (có lọc máu) Ngăn ngừa các biến cố bất lợi do sử dụng các loại vi chất dinh dưỡng không đúng cách.
Nguồn carbohydrate dưới dạng Maltodextrin Dễ dàng hòa tan và hấp thu (không cần nước nóng), giấu được vị tanh của chất béo và vị đắng của protein. 
Kết hợp với đạm whey và casein  Giúp quá trình tổng hợp protein nhanh và dài hơn.
Không chứa chất béo động vật Giàu MUFA and PUFA, MCT, hàm lượng USFA cao hơn gấp đôi so vơi SFA.
Chất tạo ngọt: sucralose  Không gây ảnh hưởng đến nồng độ đường huyết, chuyển hóa carbohydrate hay quá trình sản sinh Insulin.
Tỷ trọng: 1.04 Có thể sử dụng qua NGT/sonde/ống.
Độ thẩm thấu thấp Để ngăn ngừa các biến cố bất lợi (tiêu chảy) 

 

Thận trọng: không thích hợp cho những bệnh nhân suy thận chưa ở giai đoạn lọc máu (chạy thận nhân tạo).

 

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

CHUẨN BỊ

Nephrisol-D có thể sử dụng bằng đường uống hoặc dùng qua ống thông mũi – dạ dày.

  • Đường uống: Để pha 1 khẩu phần 250ml, thêm dần dần 4 muỗng Nephrisol-D (61 gram) vào 200ml nước ấm và trộn đều đến khi tan hết. Một cách sử dụng khác đó là, Nephrisol-D được sử dụng như đồ ăn nhẹ, sinh tố hay bánh pudding. Không nên nấu hoặc đun sôi ở nhiệt độ cao (trên 60⁰C) vì có thể gây biến tính protein của Nephrisol-D. Có thể sử dụng Nephrisol-D giữa các bữa ăn.
  • Sử dụng qua ống: theo sự hướng dẫn của chuyên gia y tế.
  • Không sử dụng để tiêm. 

DINH DƯỠNG

1.04 kcal/mL – lượng dinh dưỡng hoàn chỉnh trong một khẩu phần, cùng với 9 acid amin thiết yếu, 7 acid amin không thiết yếu, 9 vitamin và 6 khoáng chất.

DINH DƯỠNG ĐƠN VỊ TRONG MỖI KHẨU PHẦN % SO VỚI NHU CẦU HÀNG NGÀY
Calo kCal 260
          Calo từ chất béo kCal 50
Chất béo g 6 10%
          Chất béo chuyển hóa g 0
          Chất béo bão hòa g 1.5 9%
          Cholesterol mg 10
Protein g 13 21%
Tổng Carbohydrate g 39 13%
          Sucrose g 5
          Lactose g 0
          Chất xơ g 0
Vitamin
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 (Vitamin B3) mg 3.2 20%
Vitamin B6 mg 0.37 30%
Folic acid (Vitamin B9) μg 67 15%
Pantothenic acid (Vitamin B5) mg 1 15%
Chất khoáng
Natri mg 75 3%
Kali mg 55 1%
Cali mg 183 25%
Phospho mg 85 15%
Kẽm mg 4 10%
Selen μg 5 15%
Tổng Nitơ (protein và acid amin) g 2
Các acid amin thiết yếu 
          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
Các acid amin không thiết yếu 
          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

THÀNH PHẦN

Maltodextrin, dầu thực vật (dầu hạt cải, dầu hướng dương, dầu nhân cọ và dầu dừa), Whey Protein, các acid amin, Calci Caseinate, Sucrose, các khoáng chất (Calci Carbonate, Mononatri Phosphate, Natri clorid, Magnesi oxyd, kẽm oxyd, Natri selenit), hương liệu vani nhân tạo, hương liệu sữa tự nhiên, các vitamin (Vitamin C, vitamin E, vitamin B1, vitamin B2, vitamin B3, vitamin B5, vitamin B6, vitamin B12, vitamin A, vitamin D3, acid folic, biotin) chất tạo ngọt sucralose 22mg/khẩu phần.

BẢO QUẢN

Gói đã mở cần bảo quản ở nơi khô ráo, khoáng mát và sạch sẽ. Nên sử dụng sản phẩm trong vòng 1 tháng kể từ khi mở bao bì.

Packaging & Flavor

1 hộp bao gồm 185g bột hương vani.

1 hộp tương ứng với 3 khẩu phần ăn.

FAQ

What is the content of NEPHRISOL?
NEPHRISOL is a special enteral nutrient for kidney dysfunction, has a composition of 63% carbohydrates, 7% protein and 30% fat and with mineral and vitamin contents that have been adjusted for pre-dialysis chronic kidney disease conditions. NEPHRISOL also has a low protein content, so it is in accordance with the recommended protein requirements for pre-dialysis kidney patients.
How many calories are produced from NEPHRISOL per serving?
NEPHRISOL contains calories of 260 Kcal / serving.
How many servings of NEPHRISOL can be consumed per day ?
If as a substitute food, NEPHRISOL 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.
What is the calorie density of NEPHRISOL?
The calorie density of NEPHRISOL is 1.04 so that it can be given orally or tube feeding (the density does not exceed than 1.5).
What is the osmolality of NEPHRISOL?
NEPHRISOL osmolality is 354 mOsm / kg for vanilla variants
When can NEPHRISOL be used?
NEPHRISOL can be given to chronic kidney disease (pre-dialysis stage)
How is the presentation of NEPHRISOL?
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.
How many times can NEPHRISOL be consumed a day?
NEPHRISOL 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.
Is it allowed if we put more than 4 spoons per serving to increase calorie?

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

Can NEPHRISOL be combined with other enteral nutrients?
NEPHRISOL can be combined with other enteral nutrients if needed, but the dissolution process should be done separately.
What is the preparation for NGT patients?

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

Can NEPHRISOL be given to patients with diabetes mellitus (DM)?
DM patients who are given NEPHRISOL 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.
What is the stability / method of storing NEPHRISOL before it is dissolved?
The unlocked NEPHRISOL lasts for 1 month as long as it stays in the aluminum bag. Store in a dry place with a temperature <25 degrees Celsius. It is not recommended to move NEPHRISOL into other places because it can interfere with its stability. If it is to be stored in a jar it should be together with the aluminum bag.
What is the stability / method of storing NEPHRISOL after dissolving?

NEPHRISOL which has been dissolved in 5 hours must be taken. If you have not finished drinking NEPHRISOL can be stored in the refrigerator, only afterwards it is not recommended to be heated (Microwave).

What is the source of carbohydrates used in Nephrisol?

Maltodextrin. Maltodextrin has the advantage of being easily absorbed so that it will optimize the formation of energy. Maltodextrin also dissolves easily, so the process of dissolving Nephrisol does not need to use hot water. Maltodextrin can help give volume (solid builder) by drawing water from dried products. Maltodextrin has a sweeter taste than sugar but has less sugar content, and serves to mask the fishy taste of fat and the bitter taste of protein content.

Why in the composition it has sucrose and sucralose together, what is their function?

The combination of those two sugars are to complement each other since we can't use too much sucrose to sweet the product, so we use sucralose to give the sweeter taste. However we also can't use sucralose as a single sweetener since: 1) Too much sucralose gives unpleasant aftertaste and give bad effect risk for glycemic and insulin response. 2) Sucralose itself doesn't have calorie, since this product aimed to meet the daily calorie needs for CKD patient, so sucrose addition may give worthy contribution to the calorie. 3) Sucralose is needed to mask the bitter amino acid taste.

What type of protein is used in Nephrisol?
Nephrisol 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.
Both of whey and casein contain amino acids, why in the composition stated: whey protein, casein, and also amino acids together?
To inform that beside the whey protein and casein, amino acid essential and non-essential amino acid is also clearly described, according with the guideline. Because we use premix AA, so we can describe the ratio EAA and NEAA, while other products don’t have it.
Why does Nephrisol have high biological value in protein?
Because it contains complete types of amino acids, which are needed for protein synthesis, namely essential amino acids and non-essential amino acids at the appropriate guideline ratio.
What is the source of fat used in Nephrisol?
Nephrisol is used vegetable fats: sunflower oil, canola oil and coconut oil which are rich in MUFA and PUFA, MCT, and also the content of unsaturated fatty acids higher (twice higher) than saturated fatty acids
What kind of sweetener that is used in Nephrisol?
Sucralose. Sucralose is non calorie sweetener, it is not metabolized in the body into energy and does not affect blood sugar levels, carbohydrate metabolism or insulin production
Why should Nephrisol not be dissolved in hot water?
When the protein is heated, the protein becomes clotted because the peptide bonds are destroyed by heat, because the middle group contains a positive charge and the carbonyl contains a negative charge whose kinetic increases when hot. After clotting, the peptidase enzyme can no longer work on the protein. The more peptide chains and the longer the structure, the greater the chance that the protein will be damaged by heat.
Is it possible to be given to diabetes patients?
Nephrisol 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 is given, as it is with nutritional therapy in general, glucose levels should be monitored accordingly.
What is the role of Nephrisol as a food supplement or substitute?
Both. As a food supplement Nephrisol can be consumed to meet the adequacy of protein and calories that are not met from the daily diet, as a substitute food Nephrisol can be consumed if the patient is completely unable to eat.