title: Plasma levels of marine n-3 polyunsaturated fatty acids and renal allograft survival.
abstract: BACKGROUND
  Marine n-3 polyunsaturated fatty acids (PUFAs) may exert beneficial effects on inflammation, fibrosis, endothelial function, lipid profile and blood pressure that may prevent graft loss.
  
  
  METHODS
  In this observational cohort study in Norwegian renal transplant recipients (n = 1990), transplanted between 1999 and 2011, associations between plasma marine n-3 PUFA levels and graft loss were assessed by multivariable Cox proportional hazard regression analysis. Plasma phospholipid fatty acid composition was determined by gas chromatography and individual fatty acids recorded as weight percentage (wt%) of total fatty acids in a stable phase 10 weeks after transplantation.
  
  
  RESULTS
  During a median follow-up time of 6.8 years, 569 (28.6%) renal allografts were lost, either due to patient death (n = 340, 59.8% of graft loss) or graft loss in surviving patients (n = 229, 40.2%). Plasma marine n-3 PUFA levels ranged from 1.35 to 23.87 wt%, with a median level of 7.95 wt% (interquartile range 6.20-10.03 wt%). When adjusting for established graft loss risk factors, there was a 11% reduced risk of graft loss for every 1.0 wt% increase in marine n-3 PUFA level [adjusted hazard ratio (HR) 0.89; 95% confidence interval (CI) 0.84-0.93], and a 10% reduced risk of graft loss in surviving patients (adjusted HR 0.90; 95% CI 0.84-0.97).
  
  
  CONCLUSIONS
  High levels of plasma marine n-3 PUFAs were associated with better renal allograft survival.
authors.affiliation: Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Ivar A
authors.initials: IA
authors.lastname: Eide
authors.affiliation: Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway Metabolic and Renal Research Group, UiT The Arctic University of Norway, Tromsø, Norway.
authors.forename: Trond
authors.initials: T
authors.lastname: Jenssen
authors.affiliation: Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway Institute of Clinical Medicine, The University of Oslo, Oslo, Norway.
authors.forename: Anders
authors.initials: A
authors.lastname: Hartmann
authors.affiliation: Department of Biostatistics, Epidemiology and Health Care Economics, Oslo University Hospital, Oslo, Norway.
authors.forename: Lien M
authors.initials: LM
authors.lastname: Diep
authors.affiliation: Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Dag O
authors.initials: DO
authors.lastname: Dahle
authors.affiliation: Department of Transplant Medicine, Section of Nephrology, Oslo University Hospital, Rikshospitalet, Oslo, Norway The Norwegian Renal Registry, Oslo University Hospital, Rikshospitalet, Oslo, Norway.
authors.forename: Anna V
authors.initials: AV
authors.lastname: Reisæter
authors.affiliation: Department of Medical Biochemistry, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
authors.forename: Kristian S
authors.initials: KS
authors.lastname: Bjerve
authors.affiliation: Department of Nephrology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Jeppe H
authors.initials: JH
authors.lastname: Christensen
authors.affiliation: Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Erik B
authors.initials: EB
authors.lastname: Schmidt
authors.affiliation: Department of Renal Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: My
authors.initials: M
authors.lastname: Svensson
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D015525:Fatty Acids, Omega-3 / Q000097:blood*; D005260:Female; D006084:Graft Rejection / Q000401:mortality; D006085:Graft Survival; D006801:Humans; D007676:Kidney Failure, Chronic / Q000401:mortality / Q000601:surgery*; D016030:Kidney Transplantation; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012044:Regression Analysis; D012307:Risk Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
chemical_list: D015525:Fatty Acids, Omega-3
keywords: marine n-3 fatty acids; rejection; renal graft survival