Effects of marine n-3 fatty acid supplementation in renal transplantation: A randomized controlled trial

Abstract

Marine n-3 fatty acids (FAs) may exert beneficial effects on inflammation, fibrosis, and endothelial function, which could preserve renal graft function. In this randomized controlled trial, 132 Norwegian renal transplant recipients received either 2.6 g of marine n-3 FAs or olive oil (control) daily for 44 weeks, in addition to standard care. Thirty patients did not complete the trial. The primary endpoint was change (Δ) in measured glomerular filtration rate (mGFR) during follow-up. We found no significant difference in Δ mGFR between the marine n-3 FA group and controls (6.7 vs 3.8 mL/min per 1.73 m , P = .15). Significant beneficial effects from marine n-3 FA supplementation were, however, seen in secondary endpoints plasma triglycerides, plasma high-sensitivity C-reactive protein, and brachial artery flow-mediated dilation. In the per-protocol population, the renal graft indices percent interstitial fibrosis and Chronic Allograft Damage Index also were significantly lower in the marine n-3 FA group. The cumulative incidence of adverse events did not differ between the marine n-3 FA group (n = 218) and controls (n = 240). In conclusion, marine FA supplementation did not improve renal function compared with controls, but was safe, lowered plasma triglyceride and high-sensitivity C-reactive protein levels, and improved endothelial function (Clinical.Trials.gov identifier NCT01744067).

The Effect of Marine n-3 Polyunsaturated Fatty Acids on Heart Rate Variability in Renal Transplant Recipients: A Randomized Controlled Trial

“…Baseline characteristics are presented in Table 1. Complete baseline data have previously been published [21]. During the study, plasma levels of marine n-3 PUFA increased significantly in the intervention group, compared to no change in the control group, as previously published [21].…”

“…%. Further details on study design, participants, and sample size have previously been published [21].…”

“…A number of small randomized controlled trials have shown that supplementation with marine n-3 PUFA may have a beneficial effect on lipids and blood pressure in renal transplant recipients [20], but to date, no large intervention studies with cardiovascular endpoints exists. The present study is a sub-study of the recently published trial "The effect of Omega-3 Fatty Acids in Renal Transplantation" (ORENTRA) [21] and, to our knowledge, was the first study to investigate the effect of marine n-3 PUFA on HRV and rHR in renal transplant recipients.…”

Marine n-3 fatty acid consumption in a Norwegian renal transplant cohort: Comparison of a food frequency questionnaire with plasma phospholipid marine n-3 levels

“…Antifibrotic and renoprotective effects of longterm high-dose marine n-3FA supplementation have also been shown for other cardiovascular high-risk populations like myocardial infarction survivors [5,6]. The recent "Omega-3 fatty acids in Renal Transplantation (ORENTRA)" trial performed in Norwegian RTRs found lower levels of inflammatory biomarkers, less development of renal graft fibrosis and improvement of endothelial function, as well as reduced triglyceride levels after 44 weeks of high-dose n-3FA supplementation [2].…”

“…Marine n-3 fatty acid (n-3FA) consumption may benefit cardiovascular health and renal function following renal transplantation [1,2]. Previous clinical trials in renal transplant recipients (RTRs) report lower triglyceride levels, higher high-density lipoprotein cholesterol levels and lower diastolic blood pressure after marine n-3FA supplementation [1].…”