Journal Article

Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients—a pilot study

Akber Saifullah, Bruce A. Watkins, Chandan Saha, Yong Li, Sharon M. Moe and Allon N. Friedman

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 22, issue 12, pages 3561-3567
Published in print December 2007 | ISSN: 0931-0509
Published online July 2007 | e-ISSN: 1460-2385 | DOI:
Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients—a pilot study

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Background. We previously reported that haemodialysis patients have suboptimal blood levels of the cardioprotective omega-3 polyunsaturated fatty acids (n-3 PUFA) eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. In the present pilot study, we tested the hypothesis that supplementing haemodialysis patients for 12 weeks with the American Heart Association (AHA)-recommended fish oil dose would be well tolerated and efficacious in boosting blood n-3 PUFA levels and improving cardiovascular risk biomarkers.

Methods. Twenty-seven subjects were randomized in a 2 : 1 ratio to either 1.3 g of EPA + DHA daily or placebo.

Results. At baseline, 83% of subjects consumed inadequate dietary fish and had the following erythrocyte n-3 PUFA levels (mean ± SD,% weight)—EPA: 0.3 ± 0.2, DHA: 2.9 ± 2.0, and ratio of n-6/n-3 PUFA: 4.2 ± 1.3. Supplementation induced large increases in mean blood EPA and DHA levels (% increase, P-value vs placebo group): erythrocyte—EPA: +400%, P = 0.0018, DHA: +205%, P < 0.0001; plasma—EPA: +275%, P = 0.0003, DHA: +69%, P = 0.0352. Levels in the placebo group remained relatively unchanged. The omega-3 index, a value correlating with the level of cardioprotection, increased significantly in the fish oil group. A reduction in mean C-reactive protein levels (−3.3 ± 8.1 mg/l, P = 0.0282) and a trend towards lower triglyceride levels (−24 ± 74 mg/dl, P = 0.0783) were also observed in the active vs placebo group. Minimal side effects were noted.

Conclusions. Our preliminary observations that the AHA-recommended fish oil dose is well tolerated, efficacious and may improve surrogate markers of cardiovascular disease in haemodialysis patients paves the way for larger clinical trials to confirm a clinical benefit.

Keywords: C-reactive protein; fish oil; haemodialysis; n-3; omega-3; triglyceride

Journal Article.  4032 words.  Illustrated.

Subjects: Nephrology

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