Renal effects of dietary supplementation with fish oil in cyclosporine-treated liver transplant recipients.
Nephrotoxicity is the main untoward effect of cyclosporine (CsA) treatment. Experimental and clinical data suggest that dietary supplementation with fish oil may lessen cyclosporine nephrotoxicity, possibly by lowering renal thromboxane (Tx) production. We have studied the renal effects of a daily supplementation for 2 months of 12 g fish oil (18% C20:5 n-3 eicosapentaenoic acid [EPA] and 12% C22:6 n-3 docosahexanoic acid [DHA]) in a placebo-controlled (12 g corn oil), prospective, randomized, double-blind study of stable CsA-treated liver transplant recipients. Thirteen patients ingested corn oil capsules and 13 fish oil. Compliance with dietary regimen was confirmed by fatty acid chromatography that showed increased plasma concentrations of EPA (from 0.4 +/- 0.02% to 4.6 +/- 0.5%, P < .0001) and DHA (from 1.8 +/- 0.2% to 3.9 +/- 0.1%, P < .0001) in the fish oil group and increased plasma concentration of linoleic acid (C18:2 n-6) in the corn oil group (from 25 +/- 2% to 28.4 +/- 2%, P < .001). At the end of the 2 months of the study, in the fish oil group the effective renal plasma flow increased by 22% (P = .012), the glomerular filtration rate increased by 33% (P = .057), the renal blood flow increased by 17% (P = .024), and the calculated total renal vascular resistances decreased by 20% (P = .034). In contrast, none of these parameters changed in the corn oil group. The renal functional reserve determined during L-arginine infusion, plasma renin activity (PRA), and plasma aldosterone (PA) remained unchanged during the study in either group.(ABSTRACT TRUNCATED AT 250 WORDS)
D000293:Adolescent; D000328:Adult; D016572:Cyclosporine / Q000009:adverse effects* / Q000627:therapeutic use; D004042:Dietary Fats, Unsaturated / Q000627:therapeutic use*; D004311:Double-Blind Method; D005227:Fatty Acids / Q000097:blood; D005260:Female; D005395:Fish Oils / Q000627:therapeutic use*; D005919:Glomerular Filtration Rate; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007674:Kidney Diseases / Q000139:chemically induced* / Q000517:prevention & control*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D010919:Placebos; D011446:Prospective Studies; D017596:Renal Plasma Flow, Effective; D013929:Thromboxane B2 / Q000652:urine; D014508:Urea / Q000652:urine
D004042:Dietary Fats, Unsaturated; D005227:Fatty Acids; D005395:Fish Oils; D007166:Immunosuppressive Agents; D010919:Placebos; D013929:Thromboxane B2; D016572:Cyclosporine; D014508:Urea