Effects of Fish Oil Supplementation on Kidney Transplantation

Abstract

The objective of this study was to assess the effects of omega-3 fatty acid supplementation on various kidney transplantrelated outcomes. A systematic review and meta-analysis was performed of published randomized, controlled trials (RCT). There were 16 kidney transplant RCT with a total of 812 patients. All trials evaluated fish oil with dosages that ranged from 1.2 to 5.4 g/d. No consistent benefits were observed for any outcome with the exception of a modest benefit on triglycerides. A meta-analysis of rejection episodes found no significant benefit on either early (<6 mo posttransplantation) or late episodes. The overall relative risk of having at least one rejection episode in those who received fish oil was 0.91 (95% confidence interval 0.74 to 1.10) in four studies with a follow-up of 1 yr. A meta-analysis of eight RCT of graft survival found no significant benefit (relative risk 1.00, 95% confidence interval 0.96 to 1.05). The available data (mostly derived from older studies with important methodologic limitations) do not demonstrate a consistent, clinically important benefit of fish oil in kidney transplantation.

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

“…28,29 Although renal function improved after marine n-3 FA supplementation in some studies, most trials reported a nonsignificant increase in Δ mGFR of 3-5 mL/ TA B L E 3 Effects of marine n-3 FA supplementation on change in cardiovascular endpoints during follow-up Lower respiratory tract infection 8 6 28,29 Although renal function improved after marine n-3 FA supplementation in some studies, most trials reported a nonsignificant increase in Δ mGFR of 3-5 mL/ TA B L E 3 Effects of marine n-3 FA supplementation on change in cardiovascular endpoints during follow-up Lower respiratory tract infection 8 6…”

The Association between Marine n-3 Polyunsaturated Fatty Acid Levels and Survival after Renal Transplantation

“…Three separate meta-analyses of RCTs focusing on the effect of marine n-3 PUFA supplementation after renal transplantation have reported a significant reduction in triglyceride levels, a minor reduction of diastolic BP, and slightly increased concentrations of HDL cholesterol, with possible beneficial effect on patient survival (19)(20)(21). However, effects on mortality rates could not be evaluated because of a low number of events (only seven deaths in 846 patients) and short follow-up (19,21).…”

“…In RTRs, there have been reports of improved renal function with marine n-3 PUFA supplementation (29). Most studies, however, reported no effect (19)(20)(21).…”

“…No cohort study and only small RCTs have assessed the effects of marine n-3 PUFAs in RTRs, with insufficient data to evaluate the effects on mortality (19)(20)(21). Because intake of marine n-3 PUFAs in Scandinavia is generally high, with considerable variation between individuals (22,23), our cohort is ideal for epidemiologic studies of associations between marine n-3 PUFA levels and mortality in RTRs.…”

Effects of a Diet Rich in N-3 Polyunsaturated Fatty Acids on Systemic Inflammation in Renal Transplant Recipients

“…Despite the encouraging results of some studies [18], 2 recent metanalyses did not find strong enough evidence to conclude that n-3 PUFAs could prevent acute graft rejections, increase graft survival, or improve renal function [36,37]. Part of the inconsistencies in the literature could be due to the low compliance to treatment observed in patients receiving PUFAs supplementation.…”