title: Docosahexaenoic acid is an independent predictor of all-cause mortality in hemodialysis patients.
abstract: BACKGROUND
  Dietary n-3 polyunsaturated fatty acids (PUFAs), docosahexaenoic acid (DHA) and eicosapentaenoic acid have been shown to reduce cardiovascular mortality. Patients on hemodialysis (HD) have a very high mortality from cardiovascular disease. Fish consumption reduces all-cause mortality in patients on HD. Moreover, n-3 PUFAs, especially DHA levels in red blood cells (RBCs), are associated with arteriosclerosis in patients on HD. The aim of this study was to determine whether DHA levels in RBCs predict the mortality of patients on HD in a prospective cohort study.
  
  
  METHODS
  A cohort of 176 patients (64.1 ± 12.0 (mean ± SD) years of age, 96 men and 80 women) under HD treatment was studied. The fatty acid composition of their RBCs was analyzed by gas chromatography.
  
  
  RESULTS
  During the study period of 5 years, 54 deaths occurred. After adjustment for 10 confounding factors, the Cox hazard ratio of all-cause mortality of the patients on HD in the highest DHA tertile (>8.1%, 15 deaths) was 0.43 (95% CI 0.21-0.88) compared with those patients in the lowest DHA tertile (<7.2%, 21 deaths).
  
  
  CONCLUSIONS
  The findings suggest that the level of DHA in RBCs could be an independent predictor of all-cause mortality in patients on HD.
authors.affiliation: Department of Public Health, Faculty of Medicine, University of Toyama, Japan. keihama@med.u-toyama.ac.jp
authors.forename: Kei
authors.initials: K
authors.lastname: Hamazaki
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Terashima
authors.forename: Miho
authors.initials: M
authors.lastname: Itomura
authors.forename: Shigeki
authors.initials: S
authors.lastname: Sawazaki
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Inagaki
authors.forename: Masahiro
authors.initials: M
authors.lastname: Kuroda
authors.forename: Shin
authors.initials: S
authors.lastname: Tomita
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Hirata
authors.forename: Hidekuni
authors.initials: H
authors.lastname: Inadera
authors.forename: Tomohito
authors.initials: T
authors.lastname: Hamazaki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D004281:Docosahexaenoic Acids / Q000097:blood*; D004912:Erythrocytes / Q000166:cytology; D015525:Fatty Acids, Omega-3 / Q000097:blood; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011446:Prospective Studies; D006435:Renal Dialysis / Q000009:adverse effects / Q000379:methods*
chemical_list: D015525:Fatty Acids, Omega-3; D004281:Docosahexaenoic Acids