Omega-3 Polyunsaturated Fatty Acids in Chronic Renal Insufficiency

Bilo, H. J. G.; Gans, Rijk O. B.; Donker, A. J. M.

doi:10.1159/000186301

Cited by 14 publications

(1 citation statement)

References 47 publications

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“…Unfortunately, in normal subjects and patients with renal impairment of other pharmacological treatments, like dopamine or ibopadifferent etiologies. [3][4][5][6][7] In the current study, we administered mine, have also been shown to become ineffective in cirrhotic 12 g/d of fish oil (corresponding to 6 g of EPA and DHA) to patients with renal failure. 12,18 cirrhotic patients with ascites, with and without renal fail-It is worth noting that EPA and DHA supplementation did ure.…”

Section: Discussionmentioning

confidence: 99%

Lack of renal effects of fish oil administration in patients with advanced cirrhosis and impaired glomerular filtration

Badalamenti

1997

Hepatology

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use of fish oils in these patients. (HEPATOLOGY 1997; The treatment of renal failure in cirrhotic patients 25:313-316.) with ascites remains unsatisfactory. Recent studies have shown that the dietary supplementation with fish oil improves the renal function of normal subjects, as well as that of patients with renal failure of different etioloImpaired glomerular filtration is a life-threatening compligies. We have investigated the renal effects of a daily cation of cirrhosis.1,2 It is characterized by an overwhelming supplementation for 1 month of 12 g fish oil (27% C20:5 activity of vasoconstrictors (both of systemic and intrarenal n-3 eicosapentanoic acid [EPA], and 23% C22:6 n-3 doco-origin) upon vasodilating prostaglandins and kallikrein.1 Resahexanoic acid [DHA]) in a prospective study of cir-cently, it has been shown that the dietary supplementation rhotic patients with ascites, nine with normal renal with fish oil, containing high concentrations of the marine function (group 1) and eight with renal failure (glomeru-polyunsatured fatty acids, eicosapentanoic acid (EPA) (C20:5 lar filtration rate [GFR] õ 60 mL/min, group 2). Compli-n-3) and docosahexanoic acid (DHA) (C22:6 n-3), is able to ance with the dietary regimen was confirmed by fatty improve the renal function of normal subjects, as well as that acid chromatography that showed increased plasma of patients with renal failure of different etiologies.3-7 Such concentration of EPA (from 1.5 { 0.7% to 3.7 { 0.8%, P Å effect is likely mediated by the changed synthesis of prosta-.024, in group 1; and from 0.53 { 0.3% to 2.9 { 0.8%, P Å glandins, 4 antagonism against vasoconstrictor substances, 3.03, in group 2) and of DHA (from 2.1 { 0.4% to 3.4 { 0.3%, or reduced rheological stress to the glomerulus. 8 In the cur-P Å .008, in group 1; and from 1.45 { 0.5% to 3.8 { 0.4%, rent study, we investigated the effects of a 1-month dietary P Å .05, in group 2). At the end of the study, in patients supplementation with fish oil on renal function and vasofrom group 1, the glomerular filtration rate increased active compounds in cirrhotic patients with ascites, with and by 19% (from 94 { 8 to 113 { 13 mL/min, P Å .039), and without impaired glomerular filtration. the urine flow increased by 39% (from 0.85 { 0.14 to 1.12 { 0.2 mL/min, P Å .039), while no changes occurred in PATIENTS AND METHODS the renal function of patients from group 2. No changes were observed in the urinary excretion of prostaglandinThe present study included patients who met the following crite-(PG) E 2 or of 6-keto prostaglandin-1-a (6-K-PGF 1 -a) nor ria: 1) Diagnosis of cirrhosis (based on history, clinical, and laborain plasma renin activity (PRA) or the plasma concentra-tory findings) with portal hypertension, indirectly assessed by the tion of aldosterone (PA) or antidiuretic hormone (ADH) evidence of esophageal varices at endoscopy; 2) absence of arterial in both groups. As far as undesirable effects of fish oils hypertension; respiratory, cardiac, or primary kidney disease; diabewere conside...

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Section: Discussionmentioning

confidence: 99%

Lack of renal effects of fish oil administration in patients with advanced cirrhosis and impaired glomerular filtration

Badalamenti

1997

Hepatology

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Lack of Renal Effects of Fish Oil Administration in Patients With Advanced Cirrhosis and Impaired Glomerular Filtration

et al. 1997

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The treatment of renal failure in cirrhotic patients with ascites remains unsatisfactory. Recent studies have shown that the dietary supplementation with fish oil improves the renal function of normal subjects, as well as that of patients with renal failure of different etiologies. We have investigated the renal effects of a daily supplementation for 1 month of 12 g fish oil (27% C20:5 n-3 eicosapentanoic acid [EPA], and 23% C22:6 n-3 docosahexanoic acid [DHA]) in a prospective study of cirrhotic patients with ascites, nine with normal renal function (group 1) and eight with renal failure (glomerular filtration rate [GFR] < 60 mL/min, group 2). Compliance with the dietary regimen was confirmed by fatty acid chromatography that showed increased plasma concentration of EPA (from 1.5 +/- 0.7% to 3.7 +/- 0.8%, P = .024, in group 1; and from 0.53 +/- 0.3% to 2.9 +/- 0.8%, P = .03, in group 2) and of DHA (from 2.1 +/- 0.4% to 3.4 +/- 0.3%, P = .008, in group 1; and from 1.45 +/- 0.5% to 3.8 +/- 0.4%, P = .05, in group 2). At the end of the study, in patients from group 1, the glomerular filtration rate increased by 19% (from 94 +/- 8 to 113 +/- 13 mL/min, P = .039), and the urine flow increased by 39% (from 0.85 +/- 0.14 to 1.12 +/- 0.2 mL/min, P = .039), while no changes occurred in the renal function of patients from group 2. No changes were observed in the urinary excretion of prostaglandin (PG) E2 or of 6-keto prostaglandin-1-alpha (6-K-PGF1-alpha) nor in plasma renin activity (PRA) or the plasma concentration of aldosterone (PA) or antidiuretic hormone (ADH) in both groups. As far as undesirable effects of fish oils were considered, the mean arterial pressure (MAP) decreased in both groups (group 1: from 88.6 +/- 2 to 85.3 +/- 2 mm Hg, P = .015; group 2: from 88.2 +/- 3 to 82.8 +/- 3 mm Hg, P = .05), and bleeding time displayed a significant increase when patients were considered collectively (from 744 +/- 89 to 872 +/- 106 seconds, P = .0068). In conclusion, the administration of fish oil for 1 month was unable to improve renal function in cirrhotic patients with ascites and renal failure. The occurrence of undesirable effects, such as the reduction of arterial pressure and the prolongation of bleeding time, argues against the use of fish oils in these patients.

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Organ and Metabolic Complications: Lipids/Atherosclerosis

Ritz

Nowicki²,

Wiȩcek³

Replacement of Renal Function by Dialysis

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Omega-3 Polyunsaturated Fatty Acids in Chronic Renal Insufficiency

Cited by 14 publications

References 47 publications

Lack of renal effects of fish oil administration in patients with advanced cirrhosis and impaired glomerular filtration

Lack of renal effects of fish oil administration in patients with advanced cirrhosis and impaired glomerular filtration

Lack of Renal Effects of Fish Oil Administration in Patients With Advanced Cirrhosis and Impaired Glomerular Filtration

Organ and Metabolic Complications: Lipids/Atherosclerosis

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