Capd

KAPD is a solution used for peritoneal dialysis procedures.

Indications Capda

It is used to treat the following disorders:

• renal failure of a chronic nature (in the terminal phase);
• acute renal failure (of various origins).

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Release form

The product is produced in the form of a solution, inside a double system of special bags with a volume of 2 or 2.5 liters. There are 4 such bags inside the package.

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Pharmacodynamics

The drug is an electrolyte fluid containing dextrose with a lactate buffer. The drug must be administered intraperitoneally, through a dialysis session.

In continuous outpatient peritoneal dialysis, there is a more or less constant presence of dialysis fluid (often this volume is 2 liters) inside the peritoneum. This substance is replaced with a fresh medicinal solution 3-5 times per day.

The main mechanism in conducting peritoneal dialysis sessions is the use of the peritoneum as a semi-permeable wall through which the exchange of dissolved components and water (according to their physicochemical parameters) can take place between the dialysis fluid and the blood via diffusion.

The electrolyte content of the drug is usually the same as that of physiological fluid, although it is adapted (for example, by the presence of potassium) for use in people with uremia. This allows for renal replacement therapy using intraperitoneal exchange of drug components and fluid.

During a dialysis session, elements that are normally excreted in urine (including uremic toxins (creatinine with urea), uric acid, and in addition inorganic phosphates, other dissolved components and water) are in this case excreted together with the dialysate. Fluid balance can be maintained using solutions containing different levels of glucose, which helps to remove fluid (the process of ultrafiltration).

The secondary stage of acidosis, which is metabolic in nature, is compensated by the presence of lactate in the dialysis fluid (this substance is fully metabolized, transforming into bicarbonate).

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Dosing and administration

The medicine must first be warmed to body temperature and then injected into the peritoneum through a special peritoneal catheter, which is inserted through a surgical procedure.

The infusion procedure takes 5-20 minutes. The fluid should remain inside the peritoneum for 4-8 hours (the doctor determines the exact period), after which it is drained and replaced with fresh fluid. Often, 4-times a day, fluid exchanges are performed in volumes of 1.5-2 liters. Equal time intervals should be observed between the exchange procedures. Therapy is carried out daily, in the portions prescribed by the doctor, and continues for the period required for renal replacement therapy.

Peritoneal dialysis fluids are used alone to obtain the required electrolyte composition and ultrafiltration, or they can be used in combination with other substances for similar sessions.

To monitor the effectiveness of therapy, urea and creatinine levels should be checked at regular intervals. Unless otherwise prescribed, 2 liters of the medicinal substance are used per therapeutic session. If the patient experiences discomfort at the beginning of the session (due to tension in the abdominal wall), the dose is temporarily reduced to 0.5-1.5 liters per session.

An adult usually requires 2.5 or 3 liters of the drug per session. Glucose levels and infused volumes are determined based on weight, individual tolerance, and residual renal function. The volumes of fluid used should be prescribed by the attending physician.

A maximum of 5 liters of medicinal fluid should be used per 1 dialysis session.

The medicine can be used in emergency situations, and also for a long course, taking into account the indications determined by the attending physician.

Use Capda during pregnancy

Dialysis sessions can be used only in the late stages of pregnancy, as well as during lactation, after careful consideration of the ratio of benefits and the likelihood of complications.

Contraindications

The main contraindications for performing a dialysis session:

• diseases that affect the integrity of the peritoneum or peritoneal cavity. Among these are:
  • burns, fresh wounds or other inflammations on the epidermis that have a large area (for example, dermatitis) and are located in the exit zone of the catheter used during the procedure;
  • peritonitis;
  • perforation in the abdominal area;
  • previous operations performed inside the abdomen, after which fibrous adhesions remained (in the anamnesis);
  • inflammation inside the intestine (ulcerative colitis, transmural ileitis and diverticulosis);
  • neoplasms inside the peritoneum;
  • recent surgery inside the peritoneum;
  • intestinal blockage;
  • hernias inside the peritoneum;
  • fistulas located in the abdomen, either external or internal.
• sepsis;
• pulmonary diseases, especially pneumonia;
• lactic acidosis;
• cachexia or significant weight loss (especially when there is no ability to eat normally);
• in situations where uremia cannot be treated with peritoneal dialysis;
• hyperlipidemia of a pronounced nature;
• use in people who are physically or mentally unable (due to dementia, psychosis and other diseases) to follow medical instructions regarding peritoneal dialysis sessions.

This particular solution is not used for hypo- or hypercalcemia of severe severity.

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Side effects Capda

Some loss of proteins (5-15 g per day) and amino acids (1.2-3.4 g per day) always occurs during peritoneal dialysis sessions. In addition, a loss of water-soluble vitamins and the development of hypokalemia may be observed.

The deficiency of these components should be compensated by an appropriate diet. If the dietary compensation for the lost protein is insufficient, the patient may develop hypoproteinemia.

In addition, the patient may develop flatulence. When pouring or draining the dialysate used, abdominal pain may occur. Raising the diaphragm may provoke dyspnea and the appearance of pain in the shoulder joint. Hernias, dyspeptic symptoms or peritonitis also develop, and blood pressure may increase or decrease.

If the patient has been diagnosed with diabetes mellitus, additional glucose administration may provoke hyperglycemia. Because of this, constant monitoring of blood sugar values is required during therapy.

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Overdose

Poisoning can provoke the development of hypo- or hypervolemia, electrolyte metabolism disorders and hyperglycemia in diabetics.

Symptomatic procedures are used to treat disorders.

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Interactions with other drugs

It is important to take into account that the drugs used may pass into the dialysate and then be excreted from the body along with it. Therefore, their dosage may need to be adjusted.

In case of using calcium-containing drugs or calciferol, the possibility of developing hypercalcemia must be taken into account.

Combination with diuretic drugs may lead to disturbance of EBV parameters.

Potassium levels should be monitored very carefully if digitalis is used in conjunction with treatment, as sensitivity to these medications is increased by hypokalemia.

Before deciding to add various agents to the dialysis fluid, the physician must consider the pH and salt content and evaluate the compatibility of these substances before mixing.

To avoid the risk of fibrin deposition inside the catheter, heparin is allowed to be added to the peritoneal fluid.

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Storage conditions

KAPD should be kept in a place closed to small children. Do not freeze the medicinal liquid. Temperature marks - no higher than 25 ° C.

Shelf life

KAPD can be used within 24 months from the date of manufacture of the drug.

Application for children

For children, the drug is prescribed in dosages calculated in the proportion of 30-40 ml/kg, also taking into account the age, height and weight of the child.

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Analogues

The analogues of the drug are Balance, Nutrinil PD4 (contains 1.1% amino acids), Gambrosol Trio, Dialysis solution containing glucose and low calcium levels, Dianil PD4 supplemented with glucose, as well as a 2.27% solution for dialysis procedures and Physionil 40 containing glucose.

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