title: Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients--a pilot study.
abstract: 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.
authors.affiliation: Division of Nephrology, Indiana University School of Medicine, Indianapolis IN, USA.
authors.forename: Akber
authors.initials: A
authors.lastname: Saifullah
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Watkins
authors.forename: Chandan
authors.initials: C
authors.lastname: Saha
authors.forename: Yong
authors.initials: Y
authors.lastname: Li
authors.forename: Sharon M
authors.initials: SM
authors.lastname: Moe
authors.forename: Allon N
authors.initials: AN
authors.lastname: Friedman
mesh_terms: 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
chemical_list: D005395:Fish Oils; D004281:Docosahexaenoic Acids; D002097:C-Reactive Protein; D015118:Eicosapentaenoic Acid