P rotein-energy wasting (PEW) and cachexia, a severe form of PEW, are associated with poor survival in chronic kidney disease (CKD) and may occur in 20% to 80% of hemodialysis (HD) patients. 1,2 However, the mechanisms involved in uremic PEW are complex and remain poorly understood. PEW is different from malnutrition as it cannot be overcome by nutritional supplementation. 3 To date, there are few, if any, effective therapies to improve PEW associated with CKD. 4 Whether there is an increase in resting energy expenditure (REE), and its role in PEW during CKD, remain topics of

3-Carboxy-4-methyl-5-propyl-2-furanpropionate (CMPF) is a metabolite of furan fatty acid and a marker of fish oil intake. CMPF is described as a protein-bound uremic toxin and interacts with free oxygen radicals, which can induce cell damages. However, the clinical consequences of CMPF accumulation in haemodialysis patients remain poorly documented. The aims of this study are to investigate potential association between CMPF levels and (i) biochemical and nutritional parameters; (ii) cardiovascular events and (iii) mortality. Two hundred and fifty-two patients undergoing maintenance haemodialysis were included. Routine clinical biochemistry tests and assay for CMPF by HPLC technique were performed at the inclusion. Body composition parameters were measured using a bioimpedance spectroscopy method. The enrolled patients were prospectively monitored for cardiovascular events and mortality. CMPF level was positively correlated with nutritional parameters and lean mass and is significantly higher in patients without protein-energy wasting. However, the multivariate linear regression analysis indicated that CMPF level was not independently associated with albumin, prealbumin, creatinemia and body mass index. Elevated serum CMPF was not associated with mortality and cardiovascular morbidity. Our results indicate that CMPF is not a relevant uremic toxin in haemodialysis and in contrast could be a marker of healthy diet and omega 3 intakes.

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