Es Polytamin, as a nutritional supplement, may increase metabolic burden or cause serious adverse reactions when used in specific disease states. Patients with severe liver and kidney dysfunction and congenital amino acid metabolism abnormalities need to clarify their own risks and strictly follow the following taboos and precautions.

1、 Notice for patients with severe liver and kidney dysfunction

Absolute contraindication: Patients with decompensated cirrhosis, acute liver failure, end-stage renal disease before dialysis (eGFR<30mL/min/1.73m ²), or uremia without renal replacement therapy should avoid using this product.

Protein load risk: When liver and kidney function is severely impaired, it is difficult to effectively process nitrogen-containing waste produced by amino acid metabolism. The use of this product may induce or worsen symptoms of hepatic encephalopathy and uremia.

Liquid load warning: For patients with renal failure in oliguria period, the amount of liquid required for preparation of this product may increase the retention of water and sodium, increasing the burden of heart and lung.

Alternative solutions when necessary: If nutritional support is needed, special formulas designed specifically for liver or kidney disease should be selected under the guidance of a specialist physician, and conventional products should not be used on one's own.

2、 Notice for patients with congenital amino acid metabolism abnormalities

Clear contraindications: Patients with congenital amino acid metabolism disorders such as phenylketonuria, maple syrup urine, homocysteine urine, tyrosinemia, etc. are prohibited from using this product because it contains corresponding amino acid components.

Metabolic toxicity risk: These patients lack specific enzyme systems and are unable to properly decompose certain amino acids. Ingestion can lead to the accumulation of toxic metabolites, causing serious consequences such as neurological damage and developmental delay.

Newborn screening prompt: If a baby is diagnosed with the above-mentioned diseases during newborn screening, all routine amino acid supplements should be immediately discontinued and corresponding therapeutic formulas should be used instead.

Genetic counseling and dietary guidance: Diagnosed patients and their families should receive professional genetic counseling and long-term dietary management, strictly controlling the types and intake of amino acids.

3、 Assessment that must be completed before medication

Screening for liver and kidney function: Before the first use, serum transaminase, bilirubin, creatinine, urea nitrogen, and eGFR should be checked to rule out severe functional impairment.

Check the history of metabolic diseases: Inquire in detail whether the patient or their family members have a history of feeding difficulties, growth and development delays, metabolic crises, etc. during the neonatal period. If necessary, perform blood amino acid spectrum or urine organic acid testing.

Not allowed to use on their own: Even if the high-risk population mentioned above suffers from malnutrition, they must use it under the supervision of a physician with experience in nutritional management of genetic metabolic diseases or liver/kidney diseases, and cannot purchase and take it on their own based on experience.