NephFit

Indications

Amino Acid Ketoanalogues are tablets used together with a low protein diet in people with chronic kidney disease (CKD) who are not yet on dialysis. They help supply essential building blocks for protein while reducing the waste load on the kidneys, and may help slow the decline of kidney function and reduce symptoms of uraemia (waste build up), as advised by a kidney specialist.

How It Works

Each tablet contains keto acids (amino acids without their nitrogen part) plus some essential amino acids, usually as calcium salts. In the body, the keto acids pick up nitrogen from waste products such as urea and turn into essential amino acids. This means the body can make the protein it needs while producing less urea, so a very low protein diet can be followed without malnutrition. The calcium also binds some phosphate in the gut.

Dosage and Administration

Use as prescribed by your kidney doctor. A common adult dose is about 1 tablet per 5 kg of body weight per day (for a 70 kg adult, 4 to 8 tablets three times a day), divided between the three main meals. Swallow the tablets whole during meals so they are taken together with food. They must be used with the low protein diet and calorie intake planned by your doctor or dietitian.

Interactions

The calcium content can reduce absorption of some medicines, such as Tetracycline antibiotics, Ciprofloxacin and other quinolones, Iron and Levothyroxine, if taken at the same time; leave at least 2 hours between them. Phosphate binders containing aluminium should be spaced apart. High calcium levels can increase the effect of Digoxin. Tell your doctor if you take vitamin D or other calcium products.

Contraindications

• High blood calcium (hypercalcaemia).
• Inherited disorders of amino acid metabolism (such as phenylketonuria, as some products contain an amino acid source).
• Allergy to any ingredient.

Side Effects

These tablets are usually well tolerated. Some people have stomach upset, nausea or a feeling of fullness. The most important side effect is a rise in blood calcium, which can cause tiredness, constipation, thirst, nausea and confusion.

Get urgent medical help if you have severe weakness, confusion, vomiting, an irregular heartbeat, a large drop in urine output, or swelling and breathlessness.

Pregnancy and Lactation

There is little information on use in pregnancy or breastfeeding. Kidney disease in pregnancy needs specialist care; use only if your doctor advises it.

Precautions and Warnings

Blood calcium and phosphate are checked regularly, and the dose of vitamin D or other calcium medicines may need adjusting. Follow the diet plan carefully; the tablets do not work properly without a low protein diet and enough calories. Not usually used in people already on regular dialysis unless prescribed. Some products contain phenylalanine or tyrosine.

Overdose

Taking too many may raise blood calcium. Contact your doctor; blood tests may be needed.

Therapeutic Class

Nutritional supplement for chronic kidney disease; essential amino acid and keto acid preparation.

Storage

Store below 30°C in a dry place, away from light and out of the reach of children.