Intake of Marine-Derived Omega-3 Polyunsaturated Fatty Acids and Mortality in Renal Transplant Recipients

Neto, Antonio W. Gomes; Sotomayor, Camilo G.; Pranger, Ilse G.; Berg, Else van den; Gans, Rijk O. B.; Soedamah‐Muthu, Sabita S.; Navis, Gerjan; Bakker, Stephan J. L.

doi:10.3390/nu9040363

Cited by 8 publications

(12 citation statements)

References 50 publications

(61 reference statements)

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“…Using the lowest quartile of marine n-3 PUFA as a reference, the hazard ratio for SCD in the highest quartile was 0.08 (95% CI 0.02-0.35). Neto et al showed similar results in an observational study with 627 renal transplant recipients [19], with a lower risk of all-cause and cardiovascular mortality in patients with high levels of marine n-3 PUFA. These studies are in line with epidemiological data both from the general population [13], and patients with CKD [46,47].…”

Section: Discussionmentioning

confidence: 57%

“…Two recent observational studies in renal transplant recipients have shown that high levels of marine n-3 PUFA are associated with better patient survival [12,19]. In a large cohort study, Eide et al followed 1990 Norwegian renal transplant recipients for a median of 7 years and found that high levels of marine n-3 PUFA at baseline were independently associated with lower risk of all-cause mortality, and in particular a lower risk of SCD [12].…”

Section: Discussionmentioning

confidence: 99%

“…Two recent observational studies investigated the relationship between the plasma content of marine n-3 PUFA and risk of SCD in renal transplant recipients, showing that high levels of plasma marine n-3 PUFA were inversely associated with all-cause mortality and SCD [12,19]. 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.…”

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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Resting heart rate (rHR) and heart rate variability (HRV) are non-invasive measurements that predict the risk of sudden cardiac death (SCD). Marine n-3 polyunsaturated fatty acid (PUFA) supplementation may decrease rHR, increase HRV, and reduce the risk of SCD. To date, no studies have investigated the effect of marine n-3 PUFA on HRV in renal transplant recipients. In a randomized controlled trial, 132 renal transplant recipients were randomized to receive either three 1 g capsules of marine n-3 PUFA, each containing 460 mg/g EPA and 380 mg/g DHA, or control (olive oil) for 44 weeks. HRV was calculated in the time and frequency domains during a conventional cardiovascular reflex test (response to standing, deep breathing, and Valsalva maneuver) and during 2 min of resting in the supine position. There was no significant effect of marine n-3 PUFA supplementation on time-domain HRV compared with controls. rHR decreased 3.1 bpm (± 13.1) for patients receiving marine n-3 PUFA compared to 0.8 (± 11.0) in controls (p = 0.28). In the frequency domain HRV analyses, there was a significant change in response to standing in both high and low frequency measures, 2.9 (p = 0.04, 95% CI (1.1;8)) and 2.7 (p = 0.04, 95% CI (1.1;6.5)), respectively. In conclusion, 44 weeks of supplemental marine n-3 PUFAs in renal transplant recipients significantly improved the cardiac autonomic function, assessed by measuring HRV during conventional cardiovascular reflex tests.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2019

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“…Urine samples belong to the TransplantLines cohort (http://clinicaltrials.gov Identifier: NCT02811835, University Medical Center Groningen, The Netherlands) . Control samples were obtained from transplant donors and the disease group was selected on the basis of CKD clinical diagnosis and presence of clinical parameters matching MetS World Health Organization criteria (hypertension, BMI, plasma cholesterol, and triglycerides).…”

Section: Methodsmentioning

confidence: 99%

Excessive dietary lipid intake provokes an acquired form of lysosomal lipid storage disease in the kidney

Rampanelli

Ochodnický

Vissers

et al. 2018

The Journal of Pathology

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Obesity and dyslipidaemia are features of the metabolic syndrome and risk factors for chronic kidney disease. The cellular mechanisms connecting metabolic syndrome with chronic kidney disease onset and progression remain largely unclear. We show that proximal tubular epithelium is a target site for lipid deposition upon overnutrition with a cholesterol-rich Western-type diet. Affected proximal tubule epithelial cells displayed giant vacuoles of lysosomal or autophagosomal origin, harbouring oxidised lipoproteins and concentric membrane layer structures (multilamellar bodies), reminiscent of lysosomal storage diseases. Additionally, lipidomic analysis revealed renal deposition of cholesterol and phospholipids, including lysosomal phospholipids. Proteomic profiles of renal multilamellar bodies were distinct from those of epidermis or lung multilamellar bodies and of cytoplasmic lipid droplets. Tubular multilamellar bodies were observed in kidney biopsies of obese hypercholesterolaemic patients, and the concentration of the phospholipidosis marker di-docosahexaenoyl (22:6)-bis(monoacylglycerol) phosphate was doubled in urine from individuals with metabolic syndrome and chronic kidney disease. The enrichment of proximal tubule epithelial cells with phospholipids and multilamellar bodies was accompanied by enhanced inflammation, fibrosis, tubular damage markers, and higher urinary electrolyte content. Concomitantly to the intralysosomal lipid storage, a renal transcriptional response was initiated to enhance lysosomal degradation and lipid synthesis. In cultured proximal tubule epithelial cells, inhibition of cholesterol efflux transport or oxysterol treatment induced effects very similar to the in vivo situation, such as multilamellar body and phospholipid amassing, and induction of damage, inflammatory, fibrotic, and lipogenic molecules. The onset of phospholipidosis in proximal tubule epithelial cells is a novel pathological trait in metabolic syndrome-related chronic kidney disease, and emphasises the importance of healthy lysosomes and nutrition for kidney well-being. Copyright © 2018 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

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“…Recent studies have provided valuable data of an inverse association between marine-derived omega-3 polyunsaturated fatty acids ( n -3 PUFAs), and cardiovascular and all-cause mortality in the specific clinical setting of RTRs [ 4 , 5 ]. These findings extend to earlier studies showing that n -3 PUFAs derived from sea food exert beneficial effects on inflammation, fibrosis, endothelial function, lipid profile and blood pressure [ 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Fish Intake, Circulating Mercury and Mortality in Renal Transplant Recipients

et al. 2018

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Marine-derived omega-3 polyunsaturated fatty acids (n-3 PUFAs) are inversely associated with cardiovascular and all-cause mortality in renal transplant recipients (RTRs). Recommendations to increase marine-derived n-3 PUFAs by increasing fish intake may have a drawback in concomitant stimulation of mercury intake, which could lead to higher circulating mercury concentrations and mitigation of otherwise beneficial effects of n-3 PUFAs. We aimed to monitor circulating mercury concentrations, and to prospectively evaluate whether it counteracts the potential association between fish intake and cardiovascular and all-cause mortality in a cohort of RTRs (n = 604, 53 ± 13 years-old, 57% men) with long-term follow-up (median of 5.4 years; 121 deaths). Circulating mercury concentration (median 0.30 (IQR 0.14–0.63) µg/L) positively associated with fish intake (std. β = 0.21, p < 0.001). Multivariable-adjusted Cox-proportional hazards regression analyses showed that prior to, and after additional adjustment for circulating mercury concentrations, fish intake was inversely associated with both cardiovascular (HR 0.75, 95% CI 0.58–0.96; and, HR 0.75, 95% CI 0.58–0.97, respectively) and all-cause mortality (HR 0.84, 95% CI 0.72–0.97; and, HR 0.86, 95% CI 0.74–0.99, respectively). Secondary analyses accounting for marine-derived n-3 PUFAs intake revealed associations of similar magnitude. In conclusion, we found no evidence of a counteracting effect conferred by circulating mercury concentrations on the associations between fish and marine-derived n-3 PUFAs intake and the risks of cardiovascular and all-cause mortality in RTRs.

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Intake of Marine-Derived Omega-3 Polyunsaturated Fatty Acids and Mortality in Renal Transplant Recipients

Cited by 8 publications

References 50 publications

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

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

Excessive dietary lipid intake provokes an acquired form of lysosomal lipid storage disease in the kidney

Fish Intake, Circulating Mercury and Mortality in Renal Transplant Recipients

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