Omega-3 polyunsaturated fatty acids in the treatment of kidney disease.
After more than 25 years of published investigation, including randomized controlled trials, the role of omega-3 polyunsaturated fatty acids in the treatment of kidney disease remains unclear. In vitro and in vivo experimental studies support the efficacy of omega-3 polyunsaturated fatty acids on inflammatory pathways involved with the progression of kidney disease. Clinical investigations have focused predominantly on immunoglobulin A (IgA) nephropathy. More recently, lupus nephritis, polycystic kidney disease, and other glomerular diseases have been investigated. Clinical trials have shown conflicting results for the efficacy of omega-3 polyunsaturated fatty acids in IgA nephropathy, which may relate to varying doses, proportions of eicosapentaenoic acid and docosahexaenoic acid, duration of therapy, and sample size of the study populations. Meta-analyses of clinical trials using omega-3 polyunsaturated fatty acids in IgA nephropathy have been limited by the quality of available studies. However, guidelines suggest that omega-3 polyunsaturated fatty acids should be considered in progressive IgA nephropathy. Omega-3 polyunsaturated fatty acids decrease blood pressure, a known accelerant of kidney disease progression. Well-designed, adequately powered, randomized, controlled clinical trials are required to further investigate the potential benefits of omega-3 polyunsaturated fatty acids on the progression of kidney disease and patient survival.
Fassett
Robert G
RG
Renal Research, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia. r.fassett@uq.edu.au
Gobe
Glenda C
GC
Peake
Jonathan M
JM
Coombes
Jeff S
JS
D000818:Animals; D004195:Disease Models, Animal; D018450:Disease Progression; D015525:Fatty Acids, Omega-3 / Q000008:administration & dosage*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000188:drug therapy / Q000503:physiopathology; D007674:Kidney Diseases / Q000175:diagnosis* / Q000188:drug therapy* / Q000401:mortality; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000517:prevention & control; D008297:Male; D051379:Mice; D017410:Practice Guidelines as Topic; D011793:Queensland; D016032:Randomized Controlled Trials as Topic; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
D015525:Fatty Acids, Omega-3