ProRenal QD with Omega-3™ is the first daily multivitamin developed by leading nephrologists and renal nutritionists to support health and nutrition in people with Stage1-5 CKD. Take a look at the distinct clinical advantages ProRenal QD offers in comparison to other
multivitamins and why recommending it can promote a healthier life for CKD patients.
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 has been
developed to provide the specific nutrition needed
by people with CKD.
Why Recommend ProRenal QD?
ProRenal was developed by a team of nephrologists
and renal nutritionists for people with Stages 1-4
CKD. The team used the best available scientific
evidence, including recommendations set forth in the
National Kidney Foundation Kidney Disease Outcomes
Quality Initiative (KDOQI).
Only ProRenal is uniquely tailored to meet the
needs of people with CKD. By providing such specific
and complete nutritional support, ProRenal also
forms a foundation upon which additional nutritional
or pharmacologic therapy can be prescribed based on
the patient’s individual needs.
ProRenal QD differs from existing multivitamins
in three fundamental ways:
ProRenal QD provides 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
contains 800IU of Vitamin D, a dose based on
significant supporting evidence, which is twice the
Daily Recommended Intake.
- ProRenal contains 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 ProRenal includes 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. ProRenal includes amounts
consistent with the DRI for these minerals.
ProRenal QD avoids/minimizes 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 ProRenal 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.
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 use of
fish oils (omega-3 fatty acids) for primary and
secondary prevention of coronary heart disease.
ProRenal QD includes 250 mg of EPA+DHA, sufficient
for primary prevention of CHD based on these
recommendations.