Nepro: A Specialized Nutritional Supplement for Renal Patients
Nepro is a disease-specific oral nutritional supplement (ONS) designed specifically for patients with kidney failure, particularly those on hemodialysis, to improve nutritional status and prevent malnutrition.
Definition and Classification
- Nepro is classified as a "food for special medical purposes" (FSMP), which is specially formulated for the dietary management of patients with specific medical conditions under medical supervision 1
- It falls under the category of disease-specific oral nutritional supplements (ONS), specifically designed to meet the nutritional requirements of patients with renal failure 1
- As a nutritionally complete ONS, Nepro provides a balanced composition of macro- and micronutrients tailored for renal patients 1
Composition and Design
- Nepro provides approximately 475 calories and 16.7g of protein per can (237mL), making it energy and protein-dense 2
- It contains high-oleic safflower oil, corn syrup solids, and fructo-oligosaccharides specifically formulated for the nutritional needs of hemodialysis patients 2
- Nepro includes L-carnitine (62mg per can), which is beneficial for patients with kidney disease 2
- The formula is specifically designed with modified levels of electrolytes (particularly potassium and phosphorus) to align with the needs of renal patients 3
Clinical Applications
- Nepro is primarily indicated for malnourished patients with chronic kidney disease (CKD), particularly those on maintenance hemodialysis 1, 4
- It can be used as a supplemental nutrition source when normal food intake is inadequate to meet nutritional requirements 1
- It is commonly administered during hemodialysis sessions (peridialytic) to improve patient compliance and nutritional outcomes 5
- Nepro can help maintain serum albumin levels, which is crucial as hypoalbuminemia (<3.8 g/dL) is observed in approximately half of all maintenance hemodialysis patients and is associated with increased mortality 2, 5
Clinical Benefits
- Studies show that Nepro supplementation can significantly improve nutritional status as measured by:
- Peridialytic administration of Nepro has been shown to maintain quality of life with respect to impact of physical health on daily activities 5
Administration
- Nepro can be consumed orally as a ready-to-drink liquid supplement 1
- It is commonly administered during hemodialysis sessions (peridialytic) to improve compliance 5
- The typical dosage used in clinical studies ranges from one can per dialysis session to daily supplementation, depending on the patient's nutritional needs 3, 2, 5
Safety Considerations
- Nepro is generally well-tolerated with high compliance rates (>80% of prescribed therapy consumed in studies) 5
- Serum potassium and phosphorus levels typically do not change significantly with supplementation, making it safe for renal patients 3
- Potential side effects may include diarrhea in some patients and increased blood glucose in diabetic patients 2
Alternatives and Comparisons
- Nepro is one of several renal-specific nutritional supplements available for patients with kidney disease 4
- Other options for protein supplementation in renal patients include sports protein bars, which may be advantageous for patients with fluid restrictions 6
- Studies comparing Nepro with other renal-specific supplements (like ONCE Dialyze) show similar improvements in nutritional parameters, though some newer formulations may offer additional benefits 4
Clinical Recommendation
- For malnourished hemodialysis patients with serum albumin <3.8 g/dL, Nepro supplementation should be provided during dialysis sessions to improve nutritional status and maintain quality of life. 3, 5
- Nutritional assessment and monitoring of serum albumin, body weight, and other nutritional parameters should be performed regularly to evaluate the effectiveness of supplementation 3