n-3 fatty acids reduce proteinuria in patients with chronic glomerular disease

Abstract

Dietary supplementation with n-3 polyunsaturated fatty acids (n-3 PUFA) has been shown to reduce proteinuria in experimental models of renal diseases, but their potential role in the treatment of human renal disease is unknown. We administered n-3 PUFA in the form of triglycerides [with eicosapentaenoic (EPA)+docosahexaenoic (DHA) = 3 g/day into 4 patients] and of ethyl esters (EPA+DHA = 7.7 g/day) into 10 patients (one patient twice) with chronic glomerular disease (membranous glomerulonephritis and focal glomerular sclerosis), all diagnosed histologically. Serum albumin was > 2.4 g/dl and serum creatinine < 2.5 mg/dl in all patients. Treatment was given for periods of six weeks, followed by a prolonged follow-up for 27 weeks in 10 cases. Dietary supplementation with n-3 PUFA caused the expected reduction in platelet generation of thromboxane B2 (mean +/- SEM, from 490 +/- 70 ng/ml at baseline, to 342 +/- 147 ng/ml at 6 weeks, P < 0.05) of serum triglycerides (from 236 +/- 60 to 170 +/- 43, P < 0.01), and a prolongation of the bleeding time (from 5.8 +/- 0.4 min to 7.7 +/- 0.4 min, P < 0.01) in patients treated with ethyl esters. A modest but significant reduction in serum total cholesterol was noticed (from 275 +/- 27 to 252 +/- 24 mg/dl).(ABSTRACT TRUNCATED AT 250 WORDS)

Docosahexaenoic acid affects cell signaling by altering lipid rafts

“…DHA levels in these tissues can be enriched several fold through the diet [29,37,38] and the fatty acid is primarily Figure 1. Structure of docosahexaenoic acid (DHA, 22:6 ∆4, 7, 10,13,16,19 ).…”

“…Primarily via the diet, DHA has been reported to have positive effects on an enormous variety of human afflictions including cancer [2,3], heart disease [4], rheumatoid arthritis [5], asthma [6], lupus [7], alcoholism [8], visual acuity [9], kidney disease [10], respiratory disease [11], peroxisomal disorders (Zellweger's Syndrome) [12], dermatitis [13], psoriasis [14], cystic fibrosis [15], Crohn's Disease [16], schizophrenia [17], depression [18], aggression [19l and brain development [20], malaria [21], multiple sclerosis [22], migraine headaches [23] and even suicide [18]. In fact, it is hard to find any human disorder that has not been tested with DHA.…”

Higher Intakes of Fish Protein Are Related to a Lower Risk of Microalbuminuria in Young Swedish Type 1 Diabetic Patients

“…Although in our analysis the effects of fish protein seemed stronger than that of fish fat, it cannot be determined whether fish fat gave the protective effect or other components in fish contributed to our results. A high content of n-3 polyunsaturated fatty acids have been reported, though not unambiguously, to have beneficial effects on arterial blood pressure, transcapillary escape rate of albumin, albuminuria, and kidney function in diabetic and nondiabetic patients (16,20,25,28,29). The effect of dietary protein on the progression of overt diabetic renal disease in adults has been closely examined (30,31).…”

“…To reduce the risk for CVD in diabetes, a limited intake of saturated fat and cholesterol is recommended (23). On the other hand, polyunsaturated fatty acids of the n-3 type, provided by fat in fish and seafood, may not only correct hypertriglyceridemia, but also reduce blood pressure and albuminuria in patients with chronic renal disease (18,24,25). It is controversial whether fish oil supplements in albuminuric diabetic patients are beneficial (16,20).…”

The effects of dietary lipids on gene expression and apoptosis

“…After 4 years, 40 % of the patients in the placebo group either died or had end-stage renal disease, whereas only 10 % of the patients in the FO group showed progression of disease. It appears that purified FO with antioxidant supplements may inhibit or delay the progression of renal disease by altering the production of pro-inflammatory cytokines, growth factors, and PG, perhaps decreasing activation and localization of complement, which may suppress deposition of antigen-antibody complexes in glomeruli (DeCaterina et al 1993(DeCaterina et al , 1994Gentile et al 1993;Nordkild et al 1993;Donadio et al 1994;Lin, 1994;Morphake et al 1994;Petterson et al 1994).…”