Posology: For administration as a continuous infusion.
Dosage must be adjusted for individual patient requirements.
Unless otherwise advised, in patients with acute and chronic renal failure:
Patients not receiving dialysis: 0.6 - 0.8 g AAs/kg bodyweight/day = 6 - 8 ml/kg bodyweight/day.
Patients receiving dialysis: 0.8 - 1.2 g AAs/kg bodyweight/day = 8 - 12 ml/kg bodyweight/day.
For intradialytic nutrition in patients receiving long term haemodialysis: 0.5 - 0.8 g AAs/kg bodyweight/dialysis = 5 - 8 ml/kg bodyweight/dialysis.
Maximum recommended daily dose: 0.8 - 1.2 g AAs/kg bodyweight = 8 - 12 ml/kg bodyweight, or 560 - 840 ml in a patient weighing 70 kg.
Maximum recommended infusion rates:
Parenteral nutrition: 0.1 g AAs/kg bodyweight/hour.
Intradialytic nutrition: 0.2 g AAs/kg bodyweight/hour.
Paediatric population: There is at present no clinical experience of the use of Nephrotect in children.
Method of administration: In general, amino acids should always be administered in combination with infusion solutions supplying the patient's energy requirements during parenteral nutrition.
Nephrotect can be used for total parenteral nutrition if administered in combination with energy carriers, electrolytes, vitamins, and trace elements.
For central venous infusion or in a peripheral vein if appropriately admixed with other nutrients.
Nephrotect can be administered using either separate infusion lines together with other nutritional substrates (multi-bottle/bag system), or can be mixed in one container with other solutions to give a total nutrient solution containing all components.
If Nephrotect is to be used for intradialytic nutrition, it can be injected directly into the venous drip chamber of the dialysis apparatus.
Amino acid solutions, including Nephrotect, are generally administered in combination with carbohydrates and lipids to ensure anabolic utilisation of the amino acids. An exception is the use of amino acid supplements in intradialytic nutrition, during which a dialysate containing glucose maybe used.
The duration of use depends on the clinical status of the patient.
If serum creatinine falls below 300 μmol/l, a conventional amino acid solution may be used.