Effect of intradialytic intravenous administration of omega-3 fatty acids on nutritional status and inflammatory response in hemodialysis patients: a pilot study.
OBJECTIVE
Because omega-3 polyunsaturated fatty acids (PUFAs) may have anti-inflammatory properties, we tested the hypothesis that intradialytic, intravenous omega-3 PUFA treatment, combined with dietary supplementation, can modify the inflammatory response to dialysis, and influence the nutritional status of hemodialysis (HD) patients.


METHODS
Twenty HD patients with serum albumin at <39g/L received 100mL of 10% omega-3 PUFA emulsion during 11 consecutive HD sessions. Body mass index (BMI), serum albumin, transferrin, and lipids were measured before and after treatment. Serum interleukin-6 (IL-6) and high-sensitivity C-reactive protein (hsCRP) levels were determined before and after the HD session at baseline and after 4 weeks of treatment.


RESULTS
No adverse events were evident during the study. There were no significant changes in BMI, serum albumin, transferin, total and low-density lipoprotein cholesterol, and triglycerides. Predialysis hsCRP and IL-6 did not change. There was a significant increase in hsCRP (P=.01) and a tendency of IL-6 concentration to increase during the HD session before treatment (P=.067). In contrast, neither hsCRP (P=.21) nor IL-6 (P=.26) changed during the final HD session. Neither urea reduction ratio nor Kt/V changed significantly during the study, but the normalized protein catabolic ratio increased after treatment (P=.003).


CONCLUSIONS
Short-term parenteral administration of omega-3 PUFA is safe and well-tolerated by HD patients. The intervention does not significantly influence markers of inflammation or change the nutritional status of chronic HD patients, but it may attenuate the inflammatory response to HD sessions.
Szklarek-Kubicka
Magdalena
M
Department of Nephrology, Hypertension, and Kidney Transplantation, Medical University of Łódź, Łódź 91-156, Poland.
Fijałkowska-Morawska
Jolanta
J
Zaremba-Drobnik
Danuta
D
Uciński
Andrzej
A
Czekalski
Stanisław
S
Nowicki
Michał
M
D015992:Body Mass Index; D002097:C-Reactive Protein / Q000187:drug effects; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood* / Q000188:drug therapy; D018836:Inflammation Mediators / Q000097:blood; D015850:Interleukin-6 / Q000097:blood; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000628:therapy; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000187:drug effects*; D010288:Parenteral Nutrition / Q000379:methods*; D010865:Pilot Projects; D011446:Prospective Studies; D006435:Renal Dialysis / Q000379:methods*; D012709:Serum Albumin / Q000187:drug effects; D014168:Transferrin / Q000187:drug effects
D015525:Fatty Acids, Omega-3; D018836:Inflammation Mediators; D015850:Interleukin-6; D008055:Lipids; D012709:Serum Albumin; D014168:Transferrin; D002097:C-Reactive Protein