The effect of n-3 fatty acids on lipids and lipoproteins in patients treated with chronic haemodialysis: a randomized placebo-controlled intervention study.
BACKGROUND
Patients with end-stage renal disease (ESRD) have an increased mortality, mainly due to cardiovascular disease (CVD). ESRD is accompanied by several lipid abnormalities, which may be responsible for part of the increased risk of CVD in this population. n-3 polyunsaturated fatty acids (PUFA) lower plasma triglycerides in patients with normal renal function. The aim of the present study was to examine the effect of n-3 PUFA on serum lipid and lipoproteins in patients treated with chronic haemodialysis (HD).


METHODS
In a double-blind randomized placebo-controlled design, patients with documented CVD, treated with HD for a minimum of 6 months, were randomized to treatment with n-3 PUFA or a control treatment (olive oil). A dietary intake of n-3 PUFA was assessed with a dietary questionnaire. Plasma lipids and lipoproteins and the content of n-3 PUFA in serum phospholipids were measured at baseline and after 3 months.


RESULTS
Two hundred and six patients were included. Serum phospholipid levels of n-3 PUFA were significantly higher in patients reporting a high fish intake compared to patients reporting a low fish intake. After 3 months, a significant decrease was seen in serum triglycerides in the n-3 PUFA group compared to the control group (P = 0.01). No significant effect was seen on total cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, Lp(a) or apoB.


CONCLUSIONS
In patients treated with HD, consumption of fish increases levels of n-3 PUFA. Additional supplementation with n-3 PUFA for 3 months further increases levels of n-3 PUFA and lowers serum triglycerides, but does not significantly affect other plasma lipids or lipoproteins.
Svensson
My
M
Department of Nephrology, Aalborg Hospital, Aarhus University Hospital, Hobrovej 18-20, Aalborg 9100, Denmark. my_svensson@hotmail.com
Schmidt
Erik B
EB
Jørgensen
Kaj A
KA
Christensen
Jeppe H
JH
D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000097:blood*; D015897:Comorbidity; D004311:Double-Blind Method; D050171:Dyslipidemias / Q000453:epidemiology*; D005215:Fasting / Q000502:physiology; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000453:epidemiology* / Q000628:therapy*; D008055:Lipids / Q000097:blood*; D008297:Male; D006435:Renal Dialysis; D014280:Triglycerides / Q000097:blood*
D008076:Cholesterol, HDL; D015525:Fatty Acids, Omega-3; D008055:Lipids; D014280:Triglycerides