Effect of n‐3 fatty acids on nutritional status and inflammatory markers in haemodialysis patients

Peruničić-Peković, Gordana; Rasić, Z; Pljesa, Steva; Šobajić, Sladjana; Djuričić, Ivana; Maletic, Radojka; Ristić‐Medić, Danijela

doi:10.1111/j.1440-1797.2007.00777.x

Cited by 63 publications

(60 citation statements)

References 34 publications

(58 reference statements)

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“…The essential fatty acid deficiency that caused by the accelerated lipid peroxidation at the low Hb level might be explained by oxidative stress due to the anemic condition itself. A double-blind study of patients on hemodialysis who received either fish oil, olive oil, or safflower oil had documented that patients may have increased levels of the proinflammatory prostaglandin PGE2 and that fish oil intervention may decrease these levels and improves hematocrit levels [11,37,38]. The present study showed that the relative abundance of the saturated fatty acid and the relative deficiency of eicosapentaenoic acid were greater in the plasma of HD-CAD pediatric patients than that in HD-norm.…”

Section: Discussionmentioning

confidence: 47%

Serum Lipid Profile and Plasma Fatty Acids Levels in Hemodialysis Pediatric Patients-Possible Deficiency of Essential Fatty Acids

Elshamaa

Sabry

Elghoroury

et al. 2010

Kidney

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Section: Discussionmentioning

confidence: 47%

Serum Lipid Profile and Plasma Fatty Acids Levels in Hemodialysis Pediatric Patients-Possible Deficiency of Essential Fatty Acids

Elshamaa

Sabry

Elghoroury

et al. 2010

Kidney

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“…Another hypothesis for the cardioprotective effects of fish oil supplementation is the inhibition of cytokine production, as measured directly in plasma or ex vivo, and studies have been published that support and challenge the hypothesis that n-3 LCP inhibit cytokine and CRP production (102,103,(140)(141)(142)(143)(144)(145)(146)(147)(148)(149)(150) . In their recent meta-analysis including twenty-one trials, Balk et al (151) concluded that the effect of n-3 LCP, including EPA and DHA, on CRP levels in human subjects was unconvincing.…”

Section: Effects Of Epa and Dha On Inflammationmentioning

confidence: 99%

The differential effects of EPA and DHA on cardiovascular risk factors

2011

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Compelling evidence exists for the cardioprotective benefits resulting from consumption of fatty acids from fish oils, EPA (20 :5n-3) and DHA (22 :6n-3). EPA and DHA alter membrane fluidity, interact with transcription factors such as PPAR and sterol regulatory element binding protein, and are substrates for enzymes including cyclooxygenase, lipoxygenase and cytochrome P450. As a result, fish oils may improve cardiovascular health by altering lipid metabolism, inducing haemodynamic changes, decreasing arrhythmias, modulating platelet function, improving endothelial function and inhibiting inflammatory pathways. The independent effects of EPA and DHA are poorly understood. While both EPA and DHA decrease TAG levels, only DHA appears to increase HDL and LDL particle size. Evidence to date suggests that DHA is more efficient in decreasing blood pressure, heart rate and platelet aggregation compared to EPA. Fish oil consumption appears to improve arterial compliance and endothelial function; it is not yet clear as to whether differences exist between EPA and DHA in their vascular effects. In contrast, the beneficial effect of fish oils on inflammation and insulin sensitivity observed in vitro and in animal studies has not been confirmed in human subjects. Further investigation to clarify the relative effects of consuming EPA and DHA at a range of doses would enable elaboration of current understanding regarding cardioprotective effects of consuming oily fish and algal sources of long chain n-3 PUFA, and provide clearer evidence for the clinical therapeutic potential of consuming either EPA or DHA-rich oils.

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“…Administration of EPA would be expected to help correct the relative EPA deficiency reported in hemodialysis patients [30,31,32] and increase the EPA/AA ratio that has been inversely associated with adverse CV events and markers of inflammation in this population [35,54]. The potential benefit in reducing CV risk would be expected to be associated with low treatment risk, given the well-characterized safety profile reported in the literature [40,41]; however, this profile needs to be confirmed in hemodialysis patients.…”

Section: Discussionmentioning

confidence: 99%

“…EPA levels in a study of 42 hemodialysis patients were negatively correlated with concentrations of the proinflammatory cytokines tumor necrosis factor-α ( r = −0.497; p < 0.05) and IL-6 ( r = -0.468; p = 0.03) [54]. In populations other than hemodialysis patients, EPA has been shown to increase the levels of anti-inflammatory cytokines and reduce the levels of the proinflammatory cytokines [44,55,56].…”

Section: Eicosapentaenoic Acid As a Potential Therapeutic Approach Tomentioning

confidence: 99%

Eicosapentaenoic Acid as a Potential Therapeutic Approach to Reduce Cardiovascular Risk in Patients with End-Stage Renal Disease on Hemodialysis: A Review

Borow¹,

Mason

Vijayaraghavan

2017

Cardiorenal Med

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Background: Patients with end-stage renal disease on hemodialysis have excess cardiovascular disease (CVD) burden with substantially increased CV event rates compared with the general population. Summary: Traditional interventions that, according to standard clinical guidelines, reduce CV risk such as antihypertensive therapy, diet, exercise, and statins are not similarly effective in the hemodialysis population. This raises the question of whether additional risk factors, such as enhanced inflammation and oxidative stress, may drive the increased CVD burden in hemodialysis patients. Eicosapentaenoic acid (EPA), an omega-3 polyunsaturated fatty acid, is incorporated into the atherosclerotic plaque as well as membrane phospholipid bilayers and produces beneficial effects on inflammatory and oxidative mechanisms involved in atherosclerotic plaque formation and progression. EPA levels and the ratio of EPA to the omega-6 polyunsaturated fatty acid arachidonic acid (AA) are reduced in hemodialysis patients. Serum EPA levels have been inversely correlated with proinflammatory cytokines, and the EPA/AA ratio has been inversely associated with CV events in hemodialysis cohorts. Three recent studies involving over 800 hemodialysis patients and follow-up of 2-3 years suggest that EPA therapy may improve clinical outcomes in this patient population as evidenced by significant reductions in cardiovascular mortality, all-cause mortality, and/or CV events. Key Messages: Further studies with high-purity EPA are warranted in patients on hemodialysis, especially given the fact that other interventions including antihypertensives, diet, exercise, and statins have not provided meaningful benefit.

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Effect of n‐3 fatty acids on nutritional status and inflammatory markers in haemodialysis patients

Abstract: A dietary regime with fish oil could be used in dialysis patients to slow down the development of atherosclerosis and improve nutritional parameters.

Cited by 63 publications

References 34 publications

Serum Lipid Profile and Plasma Fatty Acids Levels in Hemodialysis Pediatric Patients-Possible Deficiency of Essential Fatty Acids

Serum Lipid Profile and Plasma Fatty Acids Levels in Hemodialysis Pediatric Patients-Possible Deficiency of Essential Fatty Acids

The differential effects of EPA and DHA on cardiovascular risk factors

Eicosapentaenoic Acid as a Potential Therapeutic Approach to Reduce Cardiovascular Risk in Patients with End-Stage Renal Disease on Hemodialysis: A Review

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