Treatment of severe IgA nephropathy with omega-3 fatty acids: the effect of a "very low dose" regimen.
BACKGROUND
The effect of a "very low dose" of purified omega-3 fatty acids (PFA) in the progression of severe IgA nephropathy (IgAN) was tested, in a randomized, prospective, controlled trial.


METHODS
Fourteen patients were assigned to receive a "very low dose" of PFA (0.85 g EPA and 0.57 g PHA) and 14 patients were treated symptomatically and used as controls. Both groups were similar in terms of serum creatinine (Scr) and glomerular filtration rate (GFR) at baseline. Patients were treated for 4 years. The primary end-points were an increase of 50% or more in Scr or a decrease of 50% or more in GFR at the end of the study.


RESULTS
During treatment, 1 patient (7%) in the PFA group and 6 (43%) in the control group had an increase of 50% or more in their Scr (p<0.01). Also, 1 patient (7%) in the PFA group and 7 (50%) in the control group had a decrease of 50% or more in GFR (p<0.007). The mean annual change in Scr was 0.2 mg/dL in the PFA group and 1.0 mg/dL in the control group (p<0.01). The mean annual change in GFR was -1.4 mL/min in the PFA group and -3.0 mL/min in the control group (p <0.001). One patient in the PFA group (7%) and 6 patients in the control group (43%) (p<0.01) developed end-stage renal disease during the period of observation.


CONCLUSIONS
A "very low dose" of PFA is also effective in slowing renal progression in high-risk patients with IgAN and particularly those with advanced renal disease.
Alexopoulos
Efstathios
E
Department of Nephrology, Hippokration General Hospital, Thessaloniki, Greece. helbil@spark.net.gr
Stangou
Maria
M
Pantzaki
Aphroditi
A
Kirmizis
Dimitrios
D
Memmos
Dimitrios
D
D000328:Adult; D003404:Creatinine / Q000097:blood; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004338:Drug Combinations; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D005922:Glomerulonephritis, IGA / Q000150:complications / Q000188:drug therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011507:Proteinuria / Q000209:etiology / Q000517:prevention & control; D051437:Renal Insufficiency / Q000209:etiology / Q000517:prevention & control*; D012720:Severity of Illness Index
D004338:Drug Combinations; C045153:Maxepa; D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid; D003404:Creatinine