title: Essential polyunsaturated fatty acids, inflammation and mortality in dialysis patients.
abstract: BACKGROUND
  Polyunsaturated fatty acids (PUFA) are essential nutrients with anti-inflammatory and cardioprotective properties. We investigated the association of essential dietary PUFA intake, reflected by plasma fatty acid composition, with inflammation and mortality in dialysis patients.
  
  
  METHODS
  We recruited 222 Swedish dialysis subjects (39% women) with median age of 57 years and average 12 months of dialysis vintage. Plasma phospholipid PUFA were assessed by gas-liquid chromatography. Overall mortality was assessed after 18.4 (10th-90th percentiles: 2.3-60) months of follow-up.
  
  
  RESULTS
  Linoleic acid (LA), Mead acid (MA), α-linolenic acid (ALA) and long-chain n-3 PUFA (LC n-3; the sum of eicosapentaenoic, docosapentaenoic and docosahexaenoic acids) represented 19.7, 0.26, 0.26 and 7.64% of all fatty acids in plasma, respectively. This may reflect an adequate n-3 PUFA intake. LA was negatively (β = - 0.21, P = 0.004) but MA positively (β = 0.25, P < 0.001) associated with interleukin (IL)-6 in multivariate analyses. Neither ALA nor LC n-3 were independently associated with IL-6. During follow-up, 61 deaths and 115 kidney transplants occurred. Fully adjusted competing risk models showed that every percent increase in the proportion of plasma LA was associated with 12% reduction in mortality risk before transplantation (hazard ratio 0.88, 95% confidence interval 0.79-0.99). MA was directly associated with mortality. Neither ALA nor LC n-3 predicted outcome.
  
  
  CONCLUSIONS
  The proportion of plasma phospholipid LA is inversely associated with IL-6 and all-cause mortality in Swedish dialysis patients. We raise the hypothesis that dialysis patients could benefit from increased intake of vegetable oils, the primary source of LA in the Western-type diet.
authors.affiliation: Division of Renal Medicine and Baxter Novum, Department of Clinical Science, Intervention, and Technology, Karolinska Institutet, Stockholm, Sweden.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Huang
authors.forename: Peter
authors.initials: P
authors.lastname: Stenvinkel
authors.forename: Abdul Rashid
authors.initials: AR
authors.lastname: Qureshi
authors.forename: Ulf
authors.initials: U
authors.lastname: Risérus
authors.forename: Tommy
authors.initials: T
authors.lastname: Cederholm
authors.forename: Peter
authors.initials: P
authors.lastname: Bárány
authors.forename: Olof
authors.initials: O
authors.lastname: Heimbürger
authors.forename: Bengt
authors.initials: B
authors.lastname: Lindholm
authors.forename: Juan Jesús
authors.initials: JJ
authors.lastname: Carrero
mesh_terms: D000328:Adult; D000368:Aged; D002849:Chromatography, Gas; D003430:Cross-Sectional Studies; D005231:Fatty Acids, Unsaturated / Q000008:administration & dosage* / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007249:Inflammation / Q000209:etiology / Q000401:mortality*; D015850:Interleukin-6 / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D006435:Renal Dialysis / Q000401:mortality*; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000401:mortality*; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D005231:Fatty Acids, Unsaturated; D015850:Interleukin-6