P

IPAKITINE ®
P
IPAKITINE ®

Supporting pets with

IPAKITINE COMPOSITION Chronic R
C F
Renal Failure
Fine white powder made of :
Calcium carbonate……………………………………………..…… 10%
Chitosan (crab shell extract)……………………………………........ 8%

IPK4/2016
Lactose……………………………………………………………… 82%

IPAKITINE : DOSE RATE

1g for 5kg body weight, twice a day, combined with feed.
Drinking water should be made available for the pet

PRESENTATIONS
60 g tub
180 g tub
300 g tub

1 g spoon is available inside the tub

Unit 302.2, 6-12 Boronia Road,

Da Vinci Business Park,
Brisbane Airport, Qld, 4008
PO Box. 112 Pinkemba QLD 4008
ABN: 6400 6949 480
 1,8 2,05 1,8 2,05
C R F: H O W TO P R O LO N G L I F E 2,2 1,5 2,2 1,5

E X P E CTA N CY I N C AT S A N D D O G S ?
by fig ht ing a g a in st compen sator y mech an isms

Reduction of phosphataemia: the corner stone of CRF treatment.

Reduction of phosphataemia has been shown to be the only way that increases life expectancy in dogs and REDUCTION OF PHOSPHATAEMIA IN CATS (3)
cats whatever the stage of the disease. 1,8 2,05
Reduction of protein intake: proven ineffective on survival time 2,2 1,5 The life expectancy of cats with borderline naturally occurring CRF is 2.5 times longer when they are fed
Protein restriction has no effect on survival time (1), (4), (5). Nevertheless low protein diets are generally with phosphate restricted diets in combination, when needed, with phosphate binders.
recommended for limiting azotemia, caused by excess in protein catabolism. Special care should be given
not to reduce too much the intake of protein: it could result in protein depletion. Evolution of phosphataemia Evolution of plasma PTH
Reduction of glomerular hypertension: limited to the most severe cases

PTH plasma concentration (pg/ml)

2,5 Normal 250 Normal
Vasodilators which specifically target the efferent arteries of the glomerulus should help in decreasing
400
Phosphate * Phosphate

Phosphatemia (mmpl/l)
2,0 200 Diet group
Diet group
intraglomurular hypertension thus limiting glomerular sclerosis.
1,5 * ** Restricted 150 Restricted
In cats, no publication on clinical efficacy has been issued yet. Some preliminary results seem to show that Phosphate Phosphate
it would be effective on the most severe cases (Urine Protein to Creatinine ratio > 0.8). 1,0 Diet group 100 Diet group

0,5 50

0,0 0
Initial Mid survival Initial Mid survival

REDUCTION OF PHOSPHATAEMIA IN DOGS (1) * p<0.01 vs NPD Group (Elliott and coll. 2000) * p<0.015 vs initial diagnosis (Elliott and coll. 2000)
** p<0.002 vs initial diagnosis
Dogs fed with low phosphorus diets show They also enjoy a significant prolonged survival.
better glomerular filtration rate. Protein has no effect.
Mean cats survival

800

633

Regression analysis model of effects

600
Survival time
of dietary P on glomerular filtration rate

Days
400
24
120 Low P 264
Low P
Numbers of survivors

20 200
100 High P
High P
Percent initial GFR

16
80 Low Prot 0
12
Normal Phosphate Restricted Phosphate
60
8
High Prot Diet group Diet group
40
4 The Kaplan-Meier survival curves show a highly significant
20 Months
0 difference between the 2 groups (p=0.0036)
Months
0 0 2 4 6 8 10 12 14 16 18 20 22 24
4 8 12 16 20 24 (Elliott and coll. 2000)

(Finco and coll. 1992) (Finco and coll. 1992) (1) Effects of dietary phosphorus and protein in dogs with renal failure. Delmar R. Finco, Scott A. Brown, Wayne A. Crowell, Robert J. Duncan, Jeanne A.
Barsanti, Samuel E. Bennett. 1992 Am. Journ. Vet. Res. 53, 2264-2271.
(2) Effects of phosphorus/calcium-restricted and phosphorus/calcium-replete 32% protein diets in dogs with chronic renal failure . Delmar R. Finco, Scott A.
Brown, Wayne A. Crowell, Carlotta A. Groves, Robert J. Duncan, Jeanne A. Barsanti. 1992 Am. Journ. Vet. Res. 53, 157-163.
(3) Survival in cats with naturally occurring chronic renal failure: effect of dietary management. J. Elliott, J. M. Rawlings, P. J. Markwell, P. J. Barber. 2000
Journ. Small Anim. Pract. 41, 235-242.
(4) Protein and calorie effects on progression of induced chronic renal failure in cats. Delmar R. Finco, Scott A Brown, Cathy A. Brown, Wayne A. Crowell,
Gregory Sunwold, Tanya L. Cooper. 1998 Am. Journ. Vet. Res. 59, 575-581.
(5) Long term renal responses to high dietary protein in dogs with 75% nephrectomy. John L. Robertson, Michael Goldshmidt, David S. Kronfeld, John E.
Tomaszewski, Gary S. Hill and Kennetth C. Bovee. 1986, Kidney International, 29, 511-519.

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 P RO D U C T D E S C R I P T I O N & M O D E O F A CT I O N . I PA K I T I N E ® , A P RO V E N E F F I C ACY.

Ipakitine® is a complete and optimised combination of chitosan and calcium carbonate. Both Ipakitine® was the subject of a comparative study at the Veterinary University of Vienna in 2003 (6).
substances play their role in binding phosphates. In addition chitosan binds some uraemic toxins, It was aimed at assessing Ipakitine efficacy in reducing phosphataemia and uraemia. It involved both
causes of the clinical symptoms. healthy young cats and cats with early stage naturally occurring chronic renal failure.
Years of use in the field has confirmed the very high palatability of Ipakitine. This is very important
in the case of CRF and especially for cats.
IPAKITINE ® REDUCES PHOSPHORUS
BLOOD CONCENTRATION
CALCIUM CARBONATE: THE PHOSPHATE ELIMINATOR AGENT
IPAKITINE® LOWERS PHOSPHORUS ABSORPTION IN NORMAL CATS
• Calcium carbonate belongs to the short list of substances commonly used in human medicine to bind
phosphate in patients with CRF:
• Calcium carbonate is safe. It is not an aluminium based phosphorus binding agent. Apparent digestibility of phosphates
Aluminium accumulates in various tissues of the body including bones and brain and 45
40
may lead to encephalopathy, anaemia, bone disease…
35
30

Digestibility rate
25

CHITOSAN: THE RENO-PROTECTIVE AGENT 20

15
*

10
•C hitosan results from the de-acetylation of the chitin of crabs. There are many different 5
types of chitosan according to their molecular weight and de-acetylation rate. 0
Maintenance diet Maintenance diet
without Ipakitine with Ipakitine

* significant difference p < 0.05 (Wagner and coll. 2004)

H H H
CH2 OH 0 H0 NH2 0
H H IPAKITINE® LOWERS PHOSPHATAEMIA IN CATS WITH CRF
H
H0 NH2 0
CH2 OH 0
H H H Ipakitine® action upon phosphatemia
1,8
1,6
1,4

•C
 hitosan has been proven to decrease blood urea and creatinine in rats, mice and human. 1,2 *

Digestibility rate
1,0

•C
 hitosan decreases blood phosphorus and urea in cats. 0,8
0,6

•C
 hitosan binds numerous uraemic toxins, in vitro. 0,4
0,2
0,0
Maintenance diet Maintenance diet
without Ipakitine with Ipakitine

* significant difference p < 0.05 (Wagner and coll. 2004)

In cats with CRF, Ipakitine decreases the serum phosphorus concentration from 1.7mmol/l (above the
normal range) to 1.1 mmol/l (within the normal range).

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 I PA K I T I N E ® , A P R O V E N E F F I CA CY. H O W A N D W H E N TO U S E I PA K I T I N E ® ?

IPAKITINE ® REDUCES URAEMIA IN CATS WITH CRF EARLIEST STAGES OF CHRONIC RENAL FAILURE:
A PREVENTATIVE MEASURE
Ipakitine® action upon uraemia
90
Reducing plasma phosphorus blood concentration is now considered as the primary goal in CRF
80 treatment. It should take place even before the reduction of protein intake.
70
60 *
MILD CHRONIC RENAL FAILURE:
Uraemia (mg/dl)

50
40
30
A PRAGMATIC ALTERNATIVE TO A RENAL DIET
20
10 Once azoatemia has been diagnosed, it is advised to lower the protein intake in order to relieve clinical
0 symptoms. Nevertheless, anorexia is a very common clinical symptom for CRF and the main one for cats.
Maintenance diet Maintenance diet
without Ipakitine with Ipakitine
In many cases it is very difficult or even impossible to make the cat change its usual diet towards a less
palatable renal diet.
* significant difference p < 0.05 (Wagner and coll. 2004)
Ipakitine® is palatable, therefore no change in the current diet is required.
Ipakitine® reduces phosphataemia and uraemia.
IPAKITINE® SHOWS EXCELLENT SAFETY Therefore Ipakitine® is a sensible and pragmatic alternative that enables the practitioner to keep close to the
main objectives of the CRF treatment: increase in survival time and improvement in health status.
All other biological parameters (TP, AST, ALT, WBC, RBC, Hk, MCV, MCH, MCHC) remained at a normal
level and especially blood calcium concentration which did not change during the 35 days of the trial.
MODERATE TO SEVERE CHRONIC RENAL FAILURE:
A COMPULSORY COMPLEMENT TO A RENAL DIET
Because at some point in the evolution of CRF, feeding with specific renal diet is not enough to limit
phosphataemia to an acceptable level, phosphorus binders must be used.
Ipakitine® is the only veterinary phosphorus binder and it offers in addition palatability, safety and beneficial
action on uraemic toxins.
In combination, ACEis may be used in the latest stages of the evolution of the disease.

Progression Death
of renal failure

Ipakitine and
renal feed
and/or ACEis
Ipakitine and
Ipakitine or renal feed
Ipakitine renal feed

(6) Effects of a dietary chitosan and calcium supplement on Ca and P metabolism in cats. E. Wagner, I. Schwendenwein, J. Zentek, BMTW 117: 7/8 (2004) Time (years)

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