Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients--a pilot study.
BACKGROUND
We previously reported that haemodialysis patients have suboptimal blood levels of the cardioprotective omega-3 polyunsaturated fatty acids (n-3 PUFA) eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. In the present pilot study, we tested the hypothesis that supplementing haemodialysis patients for 12 weeks with the American Heart Association (AHA)-recommended fish oil dose would be well tolerated and efficacious in boosting blood n-3 PUFA levels and improving cardiovascular risk biomarkers.


METHODS
Twenty-seven subjects were randomized in a 2 : 1 ratio to either 1.3 g of EPA + DHA daily or placebo.


RESULTS
At baseline, 83% of subjects consumed inadequate dietary fish and had the following erythrocyte n-3 PUFA levels (mean +/- SD,% weight)-EPA: 0.3 +/- 0.2, DHA: 2.9 +/- 2.0, and ratio of n-6/n-3 PUFA: 4.2 +/- 1.3. Supplementation induced large increases in mean blood EPA and DHA levels (% increase, P-value vs placebo group): erythrocyte-EPA: +400%, P = 0.0018, DHA: +205%, P < 0.0001; plasma-EPA: +275%, P = 0.0003, DHA: +69%, P = 0.0352. Levels in the placebo group remained relatively unchanged. The omega-3 index, a value correlating with the level of cardioprotection, increased significantly in the fish oil group. A reduction in mean C-reactive protein levels (-3.3 +/- 8.1 mg/l, P = 0.0282) and a trend towards lower triglyceride levels (-24 +/- 74 mg/dl, P = 0.0783) were also observed in the active vs placebo group. Minimal side effects were noted.


CONCLUSIONS
Our preliminary observations that the AHA-recommended fish oil dose is well tolerated, efficacious and may improve surrogate markers of cardiovascular disease in haemodialysis patients paves the way for larger clinical trials to confirm a clinical benefit.
Saifullah
Akber
A
Division of Nephrology, Indiana University School of Medicine, Indianapolis IN, USA.
Watkins
Bruce A
BA
Saha
Chandan
C
Li
Yong
Y
Moe
Sharon M
SM
Friedman
Allon N
AN
D002097:C-Reactive Protein / Q000032:analysis*; D019587:Dietary Supplements; D004281:Docosahexaenoic Acids / Q000097:blood*; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000097:blood*; D005260:Female; D005395:Fish Oils / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010865:Pilot Projects; D006435:Renal Dialysis
D005395:Fish Oils; D004281:Docosahexaenoic Acids; D002097:C-Reactive Protein; D015118:Eicosapentaenoic Acid