For Health Professionals
ProRenal QD with Omega 3® and ProRenal Vital® are the first daily multivitamins developed by leading nephrologists and renal nutritionists to support health and nutrition in people with Stage1-5 CKD, including dialysis and transplantation. Take a look at the distinct clinical advantages ProRenal QD with Omega 3® and ProRenal Vital® offer in comparison to other multivitamins and why recommending them can promote a healthier life for people with CKD.
Better Health through Better Nutrition
Chronic Kidney Disease affects 26 million Americans with many millions more at risk. People with CKD face unique health complications such as anemia, mineral and bone disorder (CKD-MBD), higher rates of cardiovascular disease, and hyperkalemia. In addition, a number of studies have documented that as GFR decreases, there is a spontaneous reduction in the intake of protein and calories. The resulting poor nutritional status increases the risk of nutrient deficiencies which can exacerbate the health complications of CKD. Proper nutrition - through diet and/or supplements - is therefore essential, and is complementary to pharmacologic therapy in people with CKD.
The absorption, metabolism, and excretion of vitamins is altered in people with CKD. For example, Vitamin A supplementation can quickly lead to toxicity, while vitamin D deficiency and insufficiency are much more common compared to the general population. To address the nutritional needs of people with CKD, multivitamins are often used. However, existing multivitamins may contain ingredients that can be harmful, inappropriate, or inadequate for people with CKD. The opportunity for healthcare providers is to promote better health through better nutrition. ProRenal QD with Omega 3® and ProRenal Vital® have been developed to provide the specific nutrition needed by people with CKD.
Why Recommend ProRenal QD®?
ProRenal QD with Omega 3® and ProRenal Vital® were developed using the best available scientific evidence, including recommendations set forth in the National Kidney Foundation Kidney Disease Outcomes Quality Initiative (KDOQI) and Kidney Disease: Improving Global Outcomes (KDIGO).
Only ProRenal® vitamins are uniquely tailored to meet the needs of people with CKD. By providing such specific and complete nutritional support, ProRenal® vitamins also form a foundation upon which additional nutritional or pharmacologic therapy can be prescribed based on the patient's individual needs.
ProRenal QD with Omega 3® and ProRenal Vital® differ from existing multivitamins in three fundamental ways:
Provide the essential vitamins and minerals (at the appropriate doses) to meet the needs of people with CKD:
- People with CKD are much more likely to have Vitamin D insufficiency or deficiency. ProRenal QD with Omega 3® and ProRenal Vital® contain 1000IU of Vitamin D (cholecalciferol), a dose based on significant supporting evidence, which is more than twice the Daily Recommended Intake.
- Contain 60mg of Vitamin C to avoid the potential for elevated oxalate levels (and subsequent risk for nephrolithiasis) seen with higher doses.
- Iron is an important part of in the treatment of anemia, and both ProRenal® vitamins include the DRI of iron.
- The B complex vitamins are well represented, including B12 and Folic Acid. The dose of folic acid is higher than the DRI because of increased need during treatment of anemia with erythropoiesis-stimulating agents. The dose of folic acid was not intended to lower homocysteine, as sufficient and conclusive evidence has shown no benefit in regards to preventing cardiovascular disease by lowering homocysteine.
- Levels of certain trace minerals (selenium, zinc, and copper) have been shown to be reduced in people with CKD but are important in the function of antioxidant enzymes. Both ProRenal® vitamins include amounts consistent with the DRI for these minerals.
ProRenal QD with Omega 3® and ProRenal Vital® avoid/minimize vitamins and minerals that could be toxic or non-beneficial for people with CKD:
- Vitamin A levels tend to increase in CKD, and doses often seen in typical multivitamins could result in toxicity (such as hypercalcemia).
- Vitamin E has been repeatedly shown to have no cardiovascular prevention benefit in people with and without CKD; indeed, long term use has been associated with increased risk of heart failure, heart failure-related hospitalizations, and all-cause mortality. The amount of Vitamin E used is minimal and is intended to prevent oxidation of the omega-3 fatty acids that are included in this product.
- Vitamin K deficiency is uncommon in CKD and can antagonize the actions of warfarin, a commonly prescribed medication in this population.
- Potassium and phosphorus were excluded from both ProRenal® vitamins because of the high potential for hyperkalemia and hyperphosphatemia in people with CKD.
- Case reports have demonstrated the possibility of chromium induced Acute Kidney Injury and new-onset CKD. There is no clear biologic function for chromium, and the evidence suggesting its use in diabetes is not sufficient to justify its potential for harm in people with CKD.
In addition, ProRenal QD® includes omega-3 fatty acids (DHA and EPA):
It is more likely for a person with CKD to die from cardiovascular disease than need renal replacement therapy (dialysis or transplantation). The American Heart Association recommends the intake of fish oils (omega-3 fatty acids) for primary and secondary prevention of coronary heart disease (CHD). ProRenal QD with Omega 3® includes 550 mg of EPA+DHA, sufficient for primary prevention of CHD based on these recommendations.