Parenteral nutrition of patients with acute or chronic renal failure, including those treated with dialysis. It can be used in intradialysis treatment.
Composition:
1000 ml of solution contains: 5.8 g of L-isoleucine, 12.8 g of L-leucine, 16.9 g of lysine acetate (corresponding to 12.0 g of L-lysine), 2.0 g of L-methionine, 3.5 g L-phenylalanine, 8.2 g L-threonine, 3.0 g L-tryptophan, 8.7 g L-valine, 8.2 g L-arginine, 9.8 g L-histidine, 6.2 g L -alanine, 0.54 N-acetyl-L -ysteine (corresponding to 0.4 g L-cysteine), 5.31 g Glycine, 3.0 g L-proline, 7.6 g L-serine, 0.6 g L -tyrosine, 3.16 g of N-glycyl-L-tyrosine (corresponding to 0.994 g of Glycine and 2.4 g of tyrosine). Energy value 1000 ml: 1,600 kJ (400 kcal). Osmolarity: 960 mOsm / l. pH: 5.5-6.5.
Action:
Amino acid solution for parenteral nutrition in patients with renal insufficiency. The product contains an almost complete set of L-amino acids in quantities suitable for the metabolism of patients with impaired renal function. As a source of tyrosine necessary for kidney failure, the solution contains a dipeptide - glycine-L-tyrosine, which cleaves immediately after administration (T0,5 - 5 min) releasing both components.
Contraindications:
Congenital defects in amino acid metabolism, severe renal failure without the possibility of hemofiltration or dialysis, acute shock, acute pulmonary edema, conduction, uncorrected heart failure, hypotonic dehydration, severe hepatic failure. Do not use in infants and children.
Precautions:
Use with caution in patients with hyponatraemia or increased serum osmolarity.
Pregnancy and lactation:
It can be used during pregnancy and breastfeeding only if the expected benefit to the mother outweighs the potential risk to the fetus or nursing baby - no clinical trial.
Side effects:
Too quick infusion may cause nausea, vomiting, chills, fever, redness of the skin, hyperammonaemia, hyperaminoacidaemia and acidosis (the infusion should be stopped immediately).
Dosage:
Intravenously (into the central vein or peripheral veins) by drip infusion, adjusting the dose individually to the patient's needs. Patients on dialysis: usually 0.8-1.2 g amino acids / kg / day (ie 8-12 ml / kg / day). Patients not dialyzed: usually 0.6-0.8 g amino acids / kg / day (ie 6-8 ml / kg / day). In intradialisation nutrition in patients undergoing long-term hemodialysis: 0.5-0.8 g amino acids / kg / day (ie 5-8 m / kg / day). The preparation is injected directly into the drip chamber of the venous part of the dialysis apparatus. The maximum daily dose is 0.8-1.2 g amino acids / kg. (ie 8-12 ml / kg body weight), i.e. 560-840 ml for a patient with an 70 kg. The maximum recommended infusion rate in parenteral nutrition is: 0.1 g amino acids / kg / h, in intradialisation nutrition 0.2 g amino acids / kg / h. The duration of application depends on the clinical condition of the patient. If the serum creatinine level drops below 300 μmol / l, conventional amino acid solutions may be used.
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