Nephrisol is a specialized nutrition (oral nutritional supplement and tube feed) formulated to meet requirements for those with renal insufficiency, help delay CKD progression for patients on pre dialysis stage.
Nephrisol contains :
- Low protein amount
- Completed with 9 essentials amino acids (High Biological Value Protein)
- Completed with 12 vitamins and 7 minerals
- Lactose free
Feature Benefit
| FEATURE | BENEFIT |
| Formula is designed for CKD | Not only fulfill daily nutrition need, but also suit for patient’s medical condition. |
| Low protein | Preserved kidney function in predialysis condition. |
| High biological value protein with 9 essential amino acids | To improve albumin level |
| Mineral adjusted for CKD 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) |
References :
1.Bellizzi V. Low Protein Diet or Nutritional Therapy in Chronic Kidney Disease?. Blood Purif 2013; 36:41-6.
2.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
3.Fouque D. Low Protein, Amino Acid and Ketoacid Diets to Slow the Progression of Chronic Kidney Disease and Improved Metabolic Control of Uremia. NutrManag Renal Dis. 2013; 209-31
4.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.
5.Garneata L; Mircescu G. Effect of Low Protein Diet Supplemented With Keto Acids on Progression of Chronic Kidney Disease. J Renal Nutr, 2013; 23: 210-3
6.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.
7.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
8.NEPHRISOL[Product Information] Jakarta. Indonesia. PT Kalbe Farma Tbk; 2017
Preparation
Nephrisol 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 (+ 61 gram) into a 200 ml warmed water and mix until dissolve. Other alternative, Nephrisol 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. Consume Nephrisol 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, 11 non-essential amino acids, 12 vitamins, and 8 minerals
| NUTRITION | UNIT | PER SERVING | % DV |
| Calories | kCal | 260 | |
| Calories from fat | kCal | 50 | |
| Total Fat | g | 6 | 9% |
| Saturated fatty acid | g | 2 | 8% |
| Monounsaturated fatty acid | g | 2.5 | |
| Polyunsaturated fatty acid | g | 1.5 | |
| Protein | g | 5 | 8% |
| Total Carbohydrates | g | 48 | 16% |
| Sucrose | g | 3 | |
| Lactose | g | 0 | |
| Vitamins | |||
| Vitamin A | IU | 250 | 15% |
| Vitamin C | mg | 11 | 10% |
| Vitamin D3 | IU | 33 | 8% |
| Vitamin E | mg | 1.7 | 10% |
| Vitamin B1 | mg | 0.23 | 25% |
| Vitamin B2 | mg | 0.28 | 25% |
| Niacin | mg | 3.20 | 20% |
| Vitamin B6 | mg | 0.37 | 30% |
| Vitamin B12 | μg | 0.33 | 15% |
| Folic acid | μg | 67 | 15% |
| Pantothenic acid | mg | 1 | 15% |
| Biotin | μg | 12 | |
| Minerals | |||
| Sodium | mg | 87 | 4% |
| Potassium | mg | 46 | 2% |
| Calcium | mg | 120 | 15% |
| Phosphorus | mg | 79 | 10% |
| Magnesium | mg | 20 | 8% |
| Zinc | mg | 1.53 | 15% |
| Selenium | μg | 4.9 | 15% |
| Total N (protein & amino acids) | g | 0.73 | |
| Essential Amino Acids | |||
| Leucine | g | 0.6 | |
| Isoleucine | g | 0.4 | |
| Valine | g | 0.5 | |
| Tryptophan | g | 0.1 | |
| Phenylalanine | g | 0.4 | |
| Methionine | g | 0.4 | |
| Threonine | g | 0.3 | |
| Lysine | g | 0.4 | |
| Histidine | g | 0.2 | |
| Non Essential Amino Acids | |||
| Aspartate | g | 0.2 | |
| Glutamate | g | 0.3 | |
| Serine | g | 0.1 | |
| Glycine | g | 0.04 | |
| Arginine | g | 0.17 | |
| Alanine | g | 0.1 | |
| Tyrosine | g | 0.1 | |
| Proline | g | 0.18 | |
| Cystine | g | 0.04 | |
| Taurine | g | 0.2 | |
| Glutamine | g | 0.2 | |
Ingredients
Maltodextrin, Vegetable Oil (Canola, Sunflower, Palm Kernel and Coconut Oil), Sucrose, Amino Acids, Whey Protein, Minerals (Calcium Carbonate, Monosodium Phosphate, Potassium Chloride, Sodium Chloride, Magnesium Oxide, Zinc Oxide, Sodium Selenite), Calcium Caseinate, Artificial Vanilla Flavor, Natural Identical Milk Flavor, Vitamins (L Sodium Ascorbate, Vitamin E, 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
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
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).
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.
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.
