Fish Oil Treatment for Kidney Transplant Recipients: A Meta-Analysis of Randomized Controlled Trials

Lim, Andy; Manley, Karen J; Roberts, Matthew A; Fraenkel, Margaret

doi:10.1097/01.tp.0000258613.32993.84

Cited by 28 publications

(33 citation statements)

References 27 publications

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“…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).…”

Section: Discussionmentioning

confidence: 99%

“…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). The much higher number of patients and longer follow-up time in our study provide a possibility to evaluate mortality.…”

Section: Discussionmentioning

confidence: 99%

“…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).…”

Section: Discussionmentioning

confidence: 99%

“…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.…”

Section: Introductionmentioning

confidence: 99%

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

Eide

Jenssen

Hartmann

et al. 2015

Clinical Journal of the American Society of Nephrology

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Background and objectives Several studies have reported beneficial cardiovascular effects of marine n-3 polyunsaturated fatty acids. To date, no large studies have investigated the potential benefits of marine n-3 polyunsaturated fatty acids in recipients of renal transplants.Design, setting, participants, & measurements In this observational cohort study of 1990 Norwegian recipients of renal transplants transplanted between 1999 and 2011, associations between marine n-3 polyunsaturated fatty acid levels and mortality were investigated by stratified analysis and multivariable Cox proportional hazard regression analysis adjusting for traditional and transplant-specific mortality risk factors. Marine n-3 polyunsaturated fatty acid levels in plasma phospholipids were measured by gas chromatography in a stable phase 10 weeks after transplantation.Results There were 406 deaths (20.4%) during a median follow-up period of 6.8 years. Mortality rates were lower in patients with high marine n-3 polyunsaturated fatty acid levels ($7.95 weight percentage) compared with low levels (,7.95 weight percentage) for all age categories (pooled mortality rate ratio estimate, 0.69; 95% confidence interval, 0.57 to 0.85). When divided into quartiles according to marine n-3 polyunsaturated fatty acid levels, patients in the upper quartile compared with the lower quartile had a 56% lower risk of death (adjusted hazard ratio, 0.44; 95% confidence interval, 0.26 to 0.75) using multivariable Cox proportional hazard regression analysis. There was a lower hazard ratio for death from cardiovascular disease with high levels of marine n-3 polyunsaturated fatty acid and a lower hazard ratio for death from infectious disease with high levels of the marine n-3 polyunsaturated fatty acid eicosapentaenoic acid, whereas there was no association between total or individual marine n-3 polyunsaturated fatty acid levels and cancer mortality.Conclusions Higher plasma phospholipid marine n-3 polyunsaturated fatty acid levels were independently associated with better patient survival.

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“…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).…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Eide

Jenssen

Hartmann

et al. 2015

Clinical Journal of the American Society of Nephrology

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“…Fish oil therapy may be used for patients who are intolerant of conventional therapies but is not likely to be effective monotherapy. A recent meta-analysis of omega-3 use after renal transplantation demonstrated only modest triglyceride lowering and no decrease in CV mortality (71).…”

Section: Drug Therapymentioning

confidence: 99%

Management of Cardiovascular Disease in Renal Transplant Recipients

Shirali¹,

Bia²

2008

Clinical Journal of the American Society of Nephrology

110

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Cardiovascular disease is a major cause of graft loss and the leading cause of death in renal transplant recipients. Although there are robust data on the frequency of risk factors and their contributions to cardiovascular disease in this population, few trials have demonstrated the benefit of modifying these risk factors to reduce cardiovascular events. Nevertheless, it is widely accepted that the clinical acumen filtered through the best available studies in the general population be used to treat individual renal transplant recipients given their high cardiovascular mortality. Transplant task forces and the Kidney Disease Outcomes Quality Initiative have created guidelines for this purpose. This review examines the data available for prevention and treatment of major risk factors contributing to cardiovascular disease in renal transplant recipients. The contribution of immunosuppressive agents to each risk factor and the evidence to support lifestyle modification as well as drug therapy are examined. Reducing cardiovascular risk factors requires an integrative approach that is best accomplished by a team of health care professionals. It creates a significant challenge but one that must be met if allograft survival is to improve.

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