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DEREVIU TRAVA

DEREVIU TRAVA

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Anastasiia Shalko

Family medicine13 years of experience

Dr. Anastasiia Shalko is a general practitioner with a background in both paediatrics and general medicine. She graduated from Bogomolets National Medical University in Kyiv and completed her paediatric internship at the P.L. Shupyk National Medical Academy of Postgraduate Education. After working as a paediatrician in Kyiv, she relocated to Spain, where she has been practising general medicine since 2015, providing care for both adults and children.

Her work focuses on urgent, short-term medical concerns – situations where patients need quick guidance, symptom assessment and clear next steps. She helps people understand whether their symptoms require in-person evaluation, home management or a change in treatment. Common reasons for booking an online consultation include:

  • acute respiratory symptoms (cough, sore throat, runny nose, fever)
  • viral illnesses such as colds and seasonal infections
  • gastrointestinal complaints (nausea, diarrhoea, abdominal pain, gastroenteritis)
  • sudden changes in how a child or adult feels
  • questions about existing treatment and whether adjustments are needed
  • renewal of prescriptions when clinically appropriate
Dr. Shalko works specifically with urgent and short-term problems, providing practical recommendations and helping patients determine the safest next step. She explains symptoms clearly, guides patients through decision-making and offers straightforward medical advice for everyday acute issues.

She does not provide long-term management of chronic conditions, ongoing follow-up or comprehensive care plans for complex long-term illnesses. Her consultations are designed for acute symptoms, sudden concerns and situations where timely medical input is important.

With clinical experience in both paediatrics and general medicine, Dr. Shalko confidently supports adults and children. Her communication style is clear, simple and reassuring, helping patients feel informed and supported throughout the consultation.

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This page is for general information. Consult a doctor for personal advice. Call emergency services if symptoms are severe.
About the medicine

How to use DEREVIU TRAVA

INSTRUCTIONS for medical use of the medicinal product Balance 4.25% glucose 1.25 mmol/l calcium

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INSTRUCTIONS for medical use of the medicinal product Balance 4.25% glucose 1.25 mmol/l calcium

Balance 4.25% glucose 1.25 mmol/l calcium

Composition:

active substances: calcium chloride dihydrate; sodium chloride; sodium (S)-lactate solution (sodium (S)-lactate); magnesium chloride hexahydrate; glucose monohydrate (anhydrous glucose).

Description:

"Balance 4.25% glucose 1.25 mmol/l calcium" is supplied in a two-chamber bag. One chamber contains an alkaline lactate solution, and the other chamber contains an electrolyte solution based on glucose. Mixing of the solutions of both chambers occurs by opening the middle seam between the two chambers, resulting in the formation of a neutral ready-to-use solution.

Before mixing:

1 liter of acidic electrolyte solution based on glucose contains:

Calcium chloride dihydrate0.3675 g
Sodium chloride11.279 g
Magnesium chloride hexahydrate0.2033 g
Glucose monohydrate (anhydrous glucose)93.5 g (85.0 g)

1 liter of alkaline lactate solution contains: sodium (S)-lactate solution 15.69 g (sodium (S)-lactate 7.85 g)

After mixing:

1 liter of neutral, ready-to-use solution contains:

Calcium chloride dihydrate0.1838 g
Sodium chloride5.640 g
Sodium (S)-lactate solution (sodium (S)-lactate)7.85 g (3.925 g)
Magnesium chloride hexahydrate0.1017 g
Glucose monohydrate (anhydrous glucose)46.75 g (42.5 g)

ions:

Ca2+1.25 mmol
Na+134 mmol
Mg2+0.5 mmol
Cl-100.5 mmol
(S)-lactate35 mmol
Glucose235.8 mmol

Excipients:

water for injection, hydrochloric acid, sodium hydroxide, sodium bicarbonate.

Pharmaceutical form.

Solution for peritoneal dialysis.

Main physical and chemical properties:

A two-chamber bag containing a clear colorless aqueous solution.

Ready-to-use solution:
Theoretical osmolality509 mOsm/l
pH ≈7.0

Pharmacotherapeutic group.

Solution for peritoneal dialysis. Hypertonic solutions.

ATC code V05D B.

Pharmacological properties.

Pharmacodynamics.

"Balance 4.25% glucose 1.25 mmol/l calcium" is an electrolyte solution containing glucose and lactate buffer, intended for intraperitoneal use in the treatment of terminal stage renal failure of various genesis using continuous ambulatory peritoneal dialysis (CAPD).

Pharmacokinetics.

Uremic products (such as urea, creatinine, and uric acid), inorganic phosphates, and electrolytes such as sodium, potassium, calcium, and magnesium are removed from the body into the dialysis solution by diffusion and convection.

Non-clinical data on safety.

Non-clinical studies on the toxicity of the "Balance 4.25% glucose 1.25 mmol/l calcium" solution were not conducted.

Clinical characteristics.

Indications.

Terminal (decompensated) stage of chronic renal failure of various origins, subject to treatment with peritoneal dialysis.

Contraindications.

The "Balance 4.25% glucose 1.25 mmol/l calcium" solution should not be used in patients with lactic acidosis, severe hypokalemia, severe hypocalcemia, hypovolemia, and arterial hypotension.

Special precautions for use.

Before using the "Balance 4.25% glucose 1.25 mmol/l calcium" solution for peritoneal dialysis, it is necessary to familiarize yourself with the instructions for medical use.

Interaction with other medicinal products and other types of interactions.

The use of this solution for peritoneal dialysis may lead to a decrease in the effectiveness of other medicinal products, as they may penetrate into the dialysate and be excreted from the body together with it.

Special features of use.

The solution for peritoneal dialysis should not be administered intravenously.

Method of administration and dosage.

This solution is intended exclusively for intraperitoneal use.

Continuous ambulatory peritoneal dialysis (CAPD):

Adults: If there are no other prescriptions, the patient is prescribed 2000 ml of solution per exchange, four times a day.

Automated peritoneal dialysis (APD):

If an apparatus (slip-safe cyclator) is used for intermittent or continuous cyclic peritoneal dialysis, it is recommended to use bags of a larger volume, which allows for more than one exchange of the solution.

Handling (operation method)

The ready-to-use solution should be used immediately.

"Stay-safe" system for continuous ambulatory peritoneal dialysis (CAPD)

The bag with the solution is preheated to body temperature.

"Slip-safe" system for automated peritoneal dialysis (APD)

To start the treatment procedure, it is necessary to insert the slip-safe system connectors with the prescribed solution into the free ports of the cyclator tray.

Adverse reactions.

"Balance 4.25% glucose 1.25 mmol/l calcium" is an electrolyte solution, the composition of which is similar to that of blood.

Potential adverse reactions associated with the peritoneal dialysis solution

Endocrine system disorders: secondary hyperparathyroidism with possible bone metabolism disorders (unknown).

Potential adverse reactions of peritoneal dialysis as a method

Infections and invasions: peritonitis (very common), indicated by clouding of the dialysate being drained.

Shelf life.

The shelf life in the original packaging for sale is 2 years.

Storage conditions.

Store at a temperature not below 4 °C.

Incompatibility.

The medicinal product should be used only as prescribed by a doctor to avoid the risks of incompatibility and contamination.

Packaging.

2000 ml or 2500 ml in a two-chamber bag "stay-safe" system; 4 bags in a cardboard box with a sticker in Ukrainian or with labeling in Ukrainian and other languages;

Release category.

By prescription.

Manufacturer.

Fresenius Medical Care Deutschland GmbH.

Location of the manufacturer and address of the place of its activities.

Frankfurter Strasse 6-8, 66606 St. Wendel, Germany.

Applicant.

Fresenius Medical Care Deutschland GmbH.

Location of the applicant.

Else-Kroener-Strasse 1, 61352 Bad Homburg v.d.H., Germany.

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Online doctors for DEREVIU TRAVA

Discuss dosage, side effects, interactions, contraindications, and prescription renewal for DEREVIU TRAVA – subject to medical assessment and local rules.

5.0(14)
Doctor

Anastasiia Shalko

Family medicine13 years of experience

Dr. Anastasiia Shalko is a general practitioner with a background in both paediatrics and general medicine. She graduated from Bogomolets National Medical University in Kyiv and completed her paediatric internship at the P.L. Shupyk National Medical Academy of Postgraduate Education. After working as a paediatrician in Kyiv, she relocated to Spain, where she has been practising general medicine since 2015, providing care for both adults and children.

Her work focuses on urgent, short-term medical concerns – situations where patients need quick guidance, symptom assessment and clear next steps. She helps people understand whether their symptoms require in-person evaluation, home management or a change in treatment. Common reasons for booking an online consultation include:

  • acute respiratory symptoms (cough, sore throat, runny nose, fever)
  • viral illnesses such as colds and seasonal infections
  • gastrointestinal complaints (nausea, diarrhoea, abdominal pain, gastroenteritis)
  • sudden changes in how a child or adult feels
  • questions about existing treatment and whether adjustments are needed
  • renewal of prescriptions when clinically appropriate
Dr. Shalko works specifically with urgent and short-term problems, providing practical recommendations and helping patients determine the safest next step. She explains symptoms clearly, guides patients through decision-making and offers straightforward medical advice for everyday acute issues.

She does not provide long-term management of chronic conditions, ongoing follow-up or comprehensive care plans for complex long-term illnesses. Her consultations are designed for acute symptoms, sudden concerns and situations where timely medical input is important.

With clinical experience in both paediatrics and general medicine, Dr. Shalko confidently supports adults and children. Her communication style is clear, simple and reassuring, helping patients feel informed and supported throughout the consultation.

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With a patient-centred approach, Dr. Raevskii helps individuals manage both chronic illnesses and complex oncological cases. His consultations are guided by current medical standards and adapted to each patient’s needs.

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Common concerns addressed during consultation:

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  • Snoring, mouth breathing, enlarged adenoids.
  • Frequent colds, lingering post-viral symptoms.
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  • ENT-related check-ups and chronic condition follow-up.

Dr. Fursenko helps patients manage symptoms early, avoid complications, and receive timely treatment. Online ENT consultations are a convenient way to access care for both urgent and recurring conditions — from anywhere.

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Dr. Meneses graduated from the University of Beira Interior and has years of experience working with diverse patient populations. He is fluent in Portuguese, English, Spanish, and French.

His approach is friendly, clear, and focused on delivering practical medical advice tailored to each patient’s needs.

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Dr. Popov’s approach is rooted in evidence-based medicine, combined with individualised care tailored to each patient’s history, lifestyle, and clinical needs.

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