title: Effect of omega-3 fatty acids on kidney function after myocardial infarction: the Alpha Omega Trial.
abstract: OBJECTIVE
  Kidney function gradually decreases with age, and myocardial infarction accelerates this deterioration. Omega-3 (n-3) fatty acids may slow down the decline of kidney function. The effect of marine and plant-derived n-3 fatty acids on kidney function in patients after myocardial infarction was examined.
  
  
  METHODS
  In the Alpha Omega Trial, 2344 patients with history of myocardial infarction ages 60-80 years old (81% men) were randomized to one of four trial margarines. The patients received an additional targeted amount of 400 mg/d eicosapentaenoic acid and docosahexaenoic acid, 2 g/d α-linolenic acid, eicosapentaenoic acid-docosahexaenoic acid plus α-linolenic acid, or placebo for 40 months. Serum cystatin C and serum creatinine were assessed at baseline and after 40 months. Creatinine-cystatin C-based GFR was estimated with the Chronic Kidney Disease Epidemiology Collaboration equation.
  
  
  RESULTS
  Patients consumed 19.9 g margarine/d, providing an additional 239 mg/d eicosapentaenoic acid with 159 mg/d docosahexaenoic acid, 1.99 g/d α-linolenic acid, or both in the active treatment groups. After 40 months, compared with baseline, mean (±SD) creatinine-cystatin C-based GFR was -6.9 (±12.6), -4.8 (±13.4), -6.2 (±12.8), and -6.0 (±13.0) ml/min per 1.73 m(2) in the placebo, eicosapentaenoic acid-docosahexaenoic acid, α-linolenic acid, and eicosapentaenoic acid-docosahexaenoic acid plus α-linolenic acid groups, respectively. After 40 months, in patients receiving eicosapentaenoic acid-docosahexaenoic acid compared with placebo, the decline in creatinine-cystatin C-based GFR was 2.1 less (95% confidence interval, 0.6 to 3.6; P<0.01) ml/min per 1.73 m(2); other comparisons were not statistical significant. Odds ratios (95% confidence intervals) of incident CKD (<60 ml/min per 1.73 m(2)) and rapid decline of kidney function (≥3 ml/min per year) for eicosapentaenoic acid-docosahexaenoic acid compared with placebo were 0.83 (0.58 to 1.18) and 0.85 (0.67 to 1.08), respectively.
  
  
  CONCLUSIONS
  Long-term supplementation with 400 mg/d eicosapentaenoic acid-docosahexaenoic acid provides a small beneficial effect on kidney function in patients with a history of myocardial infarction.
authors.affiliation: Departments of Internal Medicine and Nephrology and ellen.hoogeveen@planet.nl.
authors.forename: Ellen K
authors.initials: EK
authors.lastname: Hoogeveen
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands; and.
authors.forename: Johanna M
authors.initials: JM
authors.lastname: Geleijnse
authors.affiliation: Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands; and.
authors.forename: Daan
authors.initials: D
authors.lastname: Kromhout
authors.affiliation: Departments of Medical Statistics and Bioinformatics and.
authors.forename: Theo
authors.initials: T
authors.lastname: Stijnen
authors.affiliation: Clinical Chemistry, Jeroen Bosch Hospital, Den Bosch, The Netherlands;
authors.forename: Eugenie F
authors.initials: EF
authors.lastname: Gemen
authors.affiliation: Clinical Chemistry, Jeroen Bosch Hospital, Den Bosch, The Netherlands;
authors.forename: Ron
authors.initials: R
authors.lastname: Kusters
authors.affiliation: Psychiatry, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Erik J
authors.initials: EJ
authors.lastname: Giltay
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D016009:Chi-Square Distribution; D003404:Creatinine / Q000097:blood; D055316:Cystatin C / Q000097:blood; D018450:Disease Progression; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D004311:Double-Blind Method; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage*; D005260:Female; D005527:Food, Fortified; D005919:Glomerular Filtration Rate; D006801:Humans; D007668:Kidney / Q000503:physiopathology*; D016015:Logistic Models; D008297:Male; D008383:Margarine; D008875:Middle Aged; D008954:Models, Biological; D009203:Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000178:diet therapy* / Q000503:physiopathology; D009426:Netherlands; D016017:Odds Ratio; D051436:Renal Insufficiency, Chronic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D017962:alpha-Linolenic Acid / Q000008:administration & dosage*
chemical_list: D015415:Biomarkers; C525030:CST3 protein, human; D055316:Cystatin C; D017962:alpha-Linolenic Acid; D004281:Docosahexaenoic Acids; D008383:Margarine; D015118:Eicosapentaenoic Acid; D003404:Creatinine
keywords: CKD; cardiovascular disease; clinical trial; nutrition; omega-3 fatty acids
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