title: Intake of Marine-Derived Omega-3 Polyunsaturated Fatty Acids and Mortality in Renal Transplant Recipients.
abstract: The effect of marine-derived omega-3 polyunsaturated fatty acids (n-3 PUFA) on long-term outcome in renal transplant recipients (RTR) remains unclear. We investigated whether marine-derivedn-3 PUFA intake is associated with all-cause and cardiovascular (CV) mortality in RTR. Intake of eicosapentaenoic acid plus docosahexaenoic acid (EPA-DHA) was assessed using a validated Food Frequency Questionnaire. Cox regression analyses were performed to evaluate the associations of EPA-DHA intake with all-cause and CV mortality. We included 627 RTR (age 53 ± 13 years). EPA-DHA intake was 102 (42-215) mg/day. During median follow-up of 5.4 years, 130 (21%) RTR died, with 52 (8.3%) due to CV causes. EPA-DHA intake was associated with lower risk of all-cause mortality (Hazard Ratio (HR) 0.85; 95% confidence interval (95% CI) 0.75-0.97). Age (p=0.03) and smoking status (p= 0.01) significantly modified this association, with lower risk of all-cause and CV mortality particularly in older (HR 0.75, 95% CI 0.61-0.92; HR 0.68, 95% CI 0.48-0.95) and non-smoking RTR (HR 0.80, 95% CI 0.68-0.93; HR 0.74, 95% CI 0.56-0.98). In conclusion, marine-derivedn-3 PUFA intake is inversely associated with risk of all-cause and CV mortality in RTR. The strongest associations were present in subgroups of patients, which adds further evidence to the plea for EPA-DHA supplementation, particularly in elderly and non-smoking RTR.
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands. a.w.gomes.neto@umcg.nl.
authors.forename: António W
authors.initials: AW
authors.lastname: Gomes Neto
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands. c.g.sotomayor.campos@umcg.nl.
authors.forename: Camilo G
authors.initials: CG
authors.lastname: Sotomayor
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands. i.g.pranger@umcg.nl.
authors.forename: Ilse G
authors.initials: IG
authors.lastname: Pranger
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands. e.van.den.berg@umcg.nl.
authors.forename: Else
authors.initials: E
authors.lastname: van den Berg
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands. r.o.b.gans@umcg.nl.
authors.forename: Rijk O B
authors.initials: RO
authors.lastname: Gans
authors.affiliation: Division of Human Nutrition, Wageningen University & Research, Droevendaalsesteeg 4, Wageningen 6708 PB, The Netherlands. sabita.soedamah-muthu@wur.nl.
authors.forename: Sabita S
authors.initials: SS
authors.lastname: Soedamah-Muthu
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands. g.j.navis@umcg.nl.
authors.forename: Gerjan J
authors.initials: GJ
authors.lastname: Navis
authors.affiliation: Department of Internal Medicine, University Medical Center Groningen, University of Groningen, Hanzeplein 1, Groningen 9700 RB, The Netherlands. s.j.l.bakker@umcg.nl.
authors.forename: Stephan J L
authors.initials: SJ
authors.lastname: Bakker
mesh_terms: D000328:Adult; D000368:Aged; D004281:Docosahexaenoic Acids / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D015118:Eicosapentaenoic Acid / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D007674:Kidney Diseases / Q000401:mortality* / Q000601:surgery*; D016030:Kidney Transplantation / Q000401:mortality*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D015596:Nutrition Assessment; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D017747:Seafood
chemical_list: D004281:Docosahexaenoic Acids; D015118:Eicosapentaenoic Acid
keywords: all-cause mortality; cardiovascular mortality; omega-3 polyunsaturated fatty acids; renal transplant recipients