Flaxseed oil supplementation decreases C-reactive protein levels in chronic hemodialysis patients

Abstract

Malnutrition and chronic inflammation in dialysis patients negatively impact their survival prognosis, and nutrients, such as omega-3 oils, are postulated to reduce proinflammatory response. In this randomized, double-blind, multicenter, placebo-controlled trial, we investigated the effects of flaxseed oil (FO) on the inflammatory state of patients with chronic renal failure undergoing renal replacement therapy with hemodialysis (HD). We hypothesized that FO supplementation lowers C-reactive protein (CRP) levels. One hundred sixty patients with chronic renal failure who received HD therapy of 3 dialysis units over a 3-month period in South Brazil were included. The patients received blind doses of FO (1 g twice a day) and placebo (mineral oil, 1 g twice a day) for a period of 120 days. Inflammation was observed in 89 patients (61%) at the beginning of the study. There was a correlation between CRP and the body mass index (R(s) = 0.22; P = .022) and high-density lipoprotein cholesterol (R(s) = -0.23; P = .032), and the CRP levels decreased significantly over time in the group that received FO compared with the control group (P < .001). During the study period, 33.3% of the FO group changed from an inflamed to a not-inflamed category, whereas only 16.9% changed in the mineral oil group (P = .04). We conclude that the administration of FO decreases the CRP levels and that inflammation in HD patients appears to be correlated to their body mass index and reduced high-density lipoprotein cholesterol levels. Studies with a larger number of patients and over a longer duration are necessary to corroborate these findings.

Effect of omega-3 fatty acid supplementation on serum lipids and vascular inflammation in patients with end-stage renal disease: a meta-analysis

“…During the initial electronic search, 285 manuscripts were identified, of which 243 were excluded including duplicates, study with other design, and unrelated studies. The full text of 42 manuscripts was retrieved, and after detailed evaluation, 23 RCTs including 20 datasets were finally selected for meta-analysis1112131415161718192021222324252627282930313233. No new eligible studies were identified in manual search.…”

“…The follow-up duration of RCTs ranged from 2 to 6 months, and the number of patients enrolled in individual RCT ranged from 15 to 206. Ten trials were conducted in Asia12141516242526273133, seven in America11181920283032, two in Europe172329, and one in Africa13. The quality of RCTs was assessed using the Jadad score34 (Table 1), and the scores more than 3 were regarded as high quality trials.…”

“…Several RCTs1112131415 have demonstrated that supplementation of O3FA may lower CVD risk factors, whereas other RCTs have revealed inconsistent results1617181920212223242526272829. Hence, in this meta-analysis, RCTs were used to determine the role of O3FA supplementation on associated serum lipids and vascular inflammation markers in patients with ESRD, and assess the role of O3FA supplementation in specific subpopulations.…”

Effects of flaxseed supplements on blood pressure: A systematic review and meta-analysis of controlled clinical trial

“…However, a recent human study proved that flaxseed might reduce inflammation by decreasing the levels of neutrophil aggregating oxylipins [6]. Furthermore, flaxseed decreases C-reactive protein, serum amyloid A, interferon-gamma, and interleukin-1ß, IL-2, IL-4, IL-6 and IL-10 in various studies [37,38]. Another component of flaxseed, a protein hydrolysate and an isolated fraction (KCl-F1) rich in arginine, has reduced SBP after 2e8 h of post oral gavage, mimicking the anti-hypertensive effects of captopril [39].…”

Flaxseed oil increases aortic reactivity to phenylephrine through reactive oxygen species and the cyclooxygenase-2 pathway in rats

“…However, higher concentrations of flaxseed oil decrease the levels of cytokines [40]. Moreover, 4 months of flaxseed oil supplementation appears to reduce the C-reactive protein levels [41]. …”