Omega-3 fatty acid supplementation as an adjunctive therapy in the treatment of chronic kidney disease: a meta-analysis

Abstract

The aim of this study was to evaluate the benefits and risks of omega-3 fatty acid supplementation in patients with chronic kidney disease. A systematic search of articles in PubMed, Embase, the Cochrane Library, and reference lists was performed to find relevant literature. All eligible studies assessed proteinuria, the serum creatinine clearance rate, the estimated glomerular filtration rate, or the occurrence of end-stage renal disease. Standard mean differences with 95% confidence intervals for continuous data were used to estimate the effects of omega-3 fatty acid supplementation on renal function, as reflected by the serum creatinine clearance rate, proteinuria, the estimated glomerular filtration rate, and relative risk. Additionally, a random-effects model was used to estimate the effect of omega-3 fatty acid supplementation on the risk of end-stage renal disease. Nine randomized controlled trials evaluating 444 patients with chronic kidney disease were included in the study. The follow-up duration ranged from 2 to 76.8 months. Compared with no or low-dose omega-3 fatty acid supplementation, any or high-dose omega-3 fatty acid supplementation, respectively, was associated with a lower risk of proteinuria (SMD: -0.31; 95% CI: -0.53 to -0.10; p=0.004) but had little or no effect on the serum creatinine clearance rate (SMD: 0.22; 95% CI: -0.40 to 0.84; p=0.482) or the estimated glomerular filtration rate (SMD: 0.14; 95% CI: -0.13 to 0.42; p=0.296). However, this supplementation was associated with a reduced risk of end-stage renal disease (RR: 0.49; 95% CI: 0.24 to 0.99; p=0.047). In sum, omega-3 fatty acid supplementation is associated with a significantly reduced risk of end-stage renal disease and delays the progression of this disease.

A Pre-transplant Blood-based Lipid Signature for Prediction of Antibody-mediated Rejection in Kidney Transplant Patients

“…In a study comparing patients with CKD progression compared to control patients, Afshinnia et al reported that CKD progression was associated with lower Cholesteryl ester (CE), diacylglycerols (DG), PC, plasmenylcholine (PC-P), PE-P, and phosphatidic acid (PA), and elevated PE and monoacylglycerols (MAG)(19). This finding suggests that patients with CKD progression with a decrease of longer acyl chains and polyunsaturated lipids might benefit from the effects of polyunsaturated fatty acid supplementation, as some previous studies have suggested(20,21). In our study, although both groups represent patients who had CKD progression, the SC group had higher PC and LPE than the AMR group and a trend for lower LPC suggesting that subpopulations with varying degrees of inflammatory milieu might exist with the CKD population.…”

The effects of omega-3 fatty acids on diabetic nephropathy: A meta-analysis of randomized controlled trials

“…Since then, 3 new studies were published including 344 patients (55% increases in sample size). Moreover, another meta-analysis on omega-3 fatty acid supplementation as adjunctive therapy in the treatment of chronic kidney disease by Jing et al [11] in 2017 suggested that omega-3 fatty acid supplementation is associated with a significantly reduced risk of end-stage renal disease and delays the progression of this disease, but in this study, diabetic patients were not included.…”

“…Long-chain omega-3 polyunsaturated fatty acids, including eicosapentaenoic acid (EPA) and docosahexaenoic acids (DHA), have shown anti-inflammatory, antithrombotic properties and benefits on kidney function [9][10][11]. There is a number of clinical trials studying in various types of kidney diseases including IgA nephropathy [12], lupus nephritis [13,14] and polycystic kidney disease [15].…”

Management of dyslipidaemia in patients with chronic kidney disease: a position paper endorsed by the Italian Society of Nephrology

“…Meta-analyses have been limited by the quality of available studies. To date, there is insufficient evidence to recommend the use of omega-3 fatty acids to prevent death, CV events or CKD progression both in pre-dialysis CKD and in ESKD patients [133][134][135]. The recent REDUCE-IT (Reduction of Cardiovascular Events with Icosapent Ethyl-Intervention Trial) supports a CV protective effect of EPA [136].…”