Nepro HP怡腎康 (高蛋白配方)

Nepro HP




The Glory Medicina
Full Prescribing Info
Enteral and oral nutrition.
Nepro HP contains the following ingredients: D-Water, corn syrup, high oleic safflower oil, (calcium, magnesium and sodium) caseinates, canola oil, sugar (sucrose), milk protein isolate, fructo-oligosaccharides, soy lecithin, natural and artificial flavors, potassium citrate, calcium carbonate, sodium citrate, cellulose gel, choline chloride, salt (sodium chloride), ascorbic acid, L-carnitine, taurine, tribasic calcium phosphate, cellulose gum, zinc sulfate, α-tocopheryl acetate, ferrous sulfate, niacinamide, calcium pantothenate, manganese sulfate, pyridoxine HCl, cupric sulfate, thiamine chloride HCl, riboflavin, β-carotene, folic acid, vitamin A palmitate, biotin, potassium iodide, sodium selenate, phylloquinone, cyanocobalamin and vitamin D3.
Nepro HP is for supplemental or a sole source nutrition and is for oral or tube feeding.
Nepro HP has a moderate protein content and provides at least 25% of recommended levels of 18 key vitamins and minerals for dialyzed patients.
Nepro HP is low in vitamins A and D, high in folic acid and vitamin B6 because metabolism of these nutrients is altered in renal patients, 2:1 Ca/P ratio to help optimize calcium and phosphorus balance. It is lactose- and gluten-free. It contains fructo-oligosaccharides (FOS), which are indigestible carbohydrates that ferment in the colon to produce short-chain fatty acids.
Caloric Distribution: See Table 1.

Click on icon to see table/diagram/image

Analysis: Per 8-fl oz Serving: 2 cal/mL; protein 16.6 g, 14% of total calories; fat 22.7 g, 43% of total calories, cholesterol <10 mg; carbohydrate 52.8 g, 43% of total calories; water 166 g*; L-carnitine 62 mg; taurine 38 mg. Carbohydrate includes 3.7 g/8 fl oz (15.6 g/L) as FOS.
Vitamins: Vitamins A 1000 IU, D 20 IU, E 12 IU, K 20 mcg, C 25 mg, folic acid 250 mcg, thiamine (B1) 0.6 mg, riboflavin (B2) 0.68 mg, B6 2.1 mg, B12 2.4 mcg, niacin 8 mg, choline 150 mg, biotin 120 mcg, pantothenic acid 4 mg. Includes 750 IU/8 fl oz (3518 IU/L) of vitamin A activity from 0.57 mg/8 fl oz (2.7 mg/L) β-carotene.
Minerals: Sodium 200 mg (8.7 mEq), potassium 250 mg (6.4 mEq), chloride 240 mg (6.8 mEq), calcium 325 mg, phosphorus 165 mg, magnesium 50 mg, iodine 38 mcg, manganese 1.3 mg, copper 0.5 mg, zinc 5.6 mg, iron 4.5 mg, selenium 24 mcg.
Amino Acids: Essential: Histidine 415 mg, isoleucine** 730.4 mg, leucine** 1527.2 mg, lysine 1245 mg, methionine 481.4 mg, phenylalanine 830 mg, threonine 730.4 mg, tryptophan 199.2 mg, valine** 979.4 mg; non-essential: Alanine 514.6 mg, arginine 564.4 mg, aspartic acid 1245 mg, cystine 99.6 mg, glutamic acid 3502.6 mg, glycine 315.4 mg, proline 1759.6 mg, serine 946.2 mg, tyrosine 830 mg.
Fatty Acids: Linoleic (18:2) 3688 mg, α-linolenic (18:3) 680 mg, lauric (12:0) 24 mg, myristic (14:0) 41 mg, palmitic (16:0) 1167 mg, stearic (18:0) 524 mg, oleic (18:1) 14,858 mg, arachidic (20:0) 110 mg. Fatty acids equal approximately 95% of total fat. In parentheses, carbon atoms/double bonds.
Density at 23°C: 1.099 g/mL; pH: 6.6.
*1 g water = 1 mL water = 1 cc water.
**Branched-chain amino acids.
Protein: The protein content of Nepro HP is adequate to replace protein and amino acids lost during dialysis and prevent catabolism of tissue proteins. The high quality protein of Nepro HP meets or surpasses the standard amino acid profile for protein of high biological value. Nepro HP is gluten-free.
Protein Profile: 14% of total calories from protein; 70 g protein/L; cal/N ratio 179:1; nonprotein cal/N ratio 154:1.
Protein Source: Calcium, magnesium and sodium caseinates 75%, milk protein isolate 25%.
Fat: The fat blend in Nepro HP is high oleic safflower oil 67%, canola oil 29% and lecithin 4%. This combination meets the American Heart Association recommendations of <10% of calories from both saturated and polyunsaturated fatty acids. Fat levels in Nepro HP, although somewhat higher than suggested for healthy persons, are within the range suggested for renal patients to achieve the high nutrient density needed to accommodate fluid restrictions.
Fat Profile: 43% of total calories from fat.
Fat Content (95.6 g/L): Polyunsaturated fatty acids 18.4 g/L; monounsaturated fatty acids 62.6 g/L, saturated fatty acids 7.9 g/L.
Omega-6/Omega-3 Ratio 5.5:1; cholesterol <30 mg/L.
Carbohydrate: Nepro HP contains corn syrup 83%, sucrose 10% and fructo-oligosaccharides 7% as the carbohydrate sources. Because renal patients may have hypertriglyceridemia and/or aversions to sweet tastes, simple sugars have been minimized. Nepro HP is lactose-free.
Carbohydrate Profile: 43% of total calories from carbohydrate; 222.3 g carbohydrate/L.
Vitamins and Minerals: Nepro HP provides nutrients at levels that meet either the RDI or Estimated Safe and Adequate Daily Dietary Intake, or recommended intakes for dialyzed renal patients for 18 key vitamins and minerals in 1900 cal (947 mL, four 8-fl oz servings). Compared to traditional medical nutritional formulations, levels of calcium, folic acid, and pyridoxine (vitamin B6) are supplemented to meet the increased requirements of dialysis patients. Vitamins A, D and C, phosphorus, sodium, potassium, chloride and magnesium levels are reduced in comparison to standard enteral products. Molybdenum and chromium are not added to Nepro HP because blood levels of these nutrients may be elevated in renal patients. Nepro HP is supplemented with the conditionally essential nutrients L-carnitine and taurine at levels within the range of typical daily intakes (261 and 160 mg/L, respectively).
Osmotic Concentration: The main determinants of the osmolality of a formula are simple carbohydrates, electrolytes and amino acids or small peptides. Calorically dense (>1 cal/mL) formulas have, as a result, a higher osmotic concentration.
Osmolality*: 665 mOsmol/kg H2O; osmolarity: 446 mOsmol/L.
*Measured on undiluted product using vapor pressure methodology.
Renal Solute Load (RSL): Renal solute load represents the solutes excreted per liter of product consumed. The major determinants of renal solute load are dietary protein and electrolytes. Each milliequivalent of sodium, potassium and chloride contributes approximately 1 mOsmol to the renal solute load; in adults, each gram of protein contributes approximately 5.7 mOsmol. The electrolyte content of Nepro HP is low to facilitate individualization of intake based on residual renal function, underlying disease(s) and other sources of electrolytes. Because of the number of clinical factors that influence electrolyte requirements, nutritional care must be individualized and electrolyte intake adjusted as necessary. (See Table 2.)

Click on icon to see table/diagram/image
A primary or supplemental source of nutrition for the dialyzed patient with low electrolyte.
Dosage/Direction for Use
Use under medical supervision. Not for parenteral use.
Oral Feeding: May be fed at room temp or chilled.
Tube Feeding: Nutrient-dense products have a higher viscosity than standard 1-1.5 cal/mL formulas. When tube feeding Nepro HP by gravity drip, a 10F or larger tube is recommended, an 8F for pump feeding. Adjust flow rate, volume and dilution according to patient's condition and tolerance.
Special Precautions
When used as a sole source of nutrition, Nepro HP may not provide adequate water. Monitor hydration status.
ATC Classification
V06DB - Fat/carbohydrates/proteins/minerals/vitamins, combinations ; Used as general nutrients.
Liqd 220 mL x 6's
Exclusive offer for doctors
Register for a MIMS account and receive free medical publications worth $768 a year.
Sign up for free
Already a member? Sign in