The Effect of n-3 Fatty Acids on Small Dense Low-Density Lipoproteins in Patients With End-Stage Renal Disease: A Randomized Placebo-Controlled Intervention Study

Sørensen, Gustav Valentin Blichfeldt; Svensson, My; Strandhave, Charlotte; Schmidt, Erik Berg; Jørgensen, Kaj Anker; Christensen, Jeppe H.

doi:10.1053/j.jrn.2015.01.021

Cited by 14 publications

(11 citation statements)

References 32 publications

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“…After the exclusion of 437 duplications, 1051 references were reviewed for eligibility. Then, two systematic reviews and 25 randomized clinical trials without relevant outcomes were excluded [31,44,45,46,47,48,49,50,51,52,53,54,55,56,57,58,59,60,61,62,63,64,65,66,67,68,69]. There were 21 references from 18 RCTs meeting the eligibility criteria (Figure 1) [10,11,12,13,14,15,16,17,18,19,20,21,22,23,24,25,26,27,28,29,30].…”

Section: Resultsmentioning

confidence: 99%

Efficacy of Polyunsaturated Fatty Acids on Inflammatory Markers in Patients Undergoing Dialysis: A Systematic Review with Network Meta-Analysis of Randomized Clinical Trials

Yeh

et al. 2019

IJMS

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The effects of polyunsaturated fatty acids (PUFAs) on inflammatory markers among patients receiving dialysis have been discussed for a long time, but previous syntheses made controversial conclusion because of highly conceptual heterogeneity in their synthesis. Thus, to further understanding of this topic, we comprehensively gathered relevant randomized clinical trials (RCTs) before April 2019, and two authors independently extracted data of C-reactive protein (CRP), high-sensitivity C-reactive protein (hs-CRP), and interleukin-6 (IL-6) for conducting network meta-analysis. Eighteen eligible RCTs with 962 patients undergoing dialysis were included in our study. The result showed that with placebo as the reference, PUFAs was the only treatment showing significantly lower CRP (weighted mean difference (WMD): −0.37, 95% confidence interval (CI): −0.07 to −0.68), but the CRP in PUFAs group was not significantly lower than vitamin E, PUFAs plus vitamin E, or medium-chain triglyceride. Although no significant changes were noted for hs-CRP and IL-6 levels, PUFAs showed the best ranking among treatments according to surface under the cumulative ranking. Therefore, PUFAs could be a protective option for patients receiving dialysis in clinical practice.

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Section: Resultsmentioning

confidence: 99%

Efficacy of Polyunsaturated Fatty Acids on Inflammatory Markers in Patients Undergoing Dialysis: A Systematic Review with Network Meta-Analysis of Randomized Clinical Trials

Yeh

et al. 2019

IJMS

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“…The 27 RCTs recruited 1975 dialysis patient from Brazil, [13,24] Canada, [14] Denmark, [15,30,32,[34][35][36] Egypt, [10] Iran, [9, 16-19, 21, 22, 25-29, 37] Korea, [8,23] and United States. [11,12,31] These trials could be categorized into six treatment strategies including placebo, omega-3 fatty acids, combination of omega-3 fatty acids and omega-6 fatty acids (n-3+n-6), combination of omega-3 fatty acids and vitamin (n-3+VitE), vitamin E, and medium chain triglyceride (MCT).…”

Section: Characteristics and Quality Of Included Studiesmentioning

confidence: 99%

The Impact of ω-6 and ω-3 fatty acids on lipoproteins in renal replacement therapy patients: A Network Meta-Analysis of Randomized Clinical Trials

Chang

Chen

Kao

et al. 2021

Preprint

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Background Numerous randomized clinical trials (RCTs) and meta-analyses have assessed the effects of supplemental dietary polyunsaturated fatty acids (PUFAs) on levels of low-density lipoproteins (LDLs) and high-density lipoproteins (HDLs), and LDL/HDL ratios in renal replacement therapy patients. However, the results have been ambiguous due to mixed reports of various nutrients used in the intervention group. We performed a network meta-analysis of randomized clinical trials to assess the effects of PUFAs on lipid profiles in renal replacement therapy patients. Methods RCTs performed prior to September 2020 were gathered from three databases. The means, standard deviations, and the number of cases for each arm were independently extracted by 2 authors for forming a network meta-analysis of LDL and HDL levels, and LDL/HDL ratios in random-effects model. Results Twenty-seven RCTs (n=1975) were included in this study. The pooled results revealed that the combination of omega-3 fatty acids (n-3) and omega-6 fatty acids (n-6) was significantly lower for the LDL (standardized mean difference [SMD]: −0.95, 95% confidence interval [CI]: −1.87 to −0.13) than the placebo, and the placebo resulted in significantly lower HDL than n-3 (SMD: −0.85, 95% CI: −1.50 to −0.20). There was no evidence of inconsistency or publication bias in the pooled results. Conclusions Collectively, PUFAs seems to be effective nutrients in controlling lipoprotein among renal replacement therapy patients. To be specific, n-3+n-6 improves LDL, and n-3 improves HDL and LDL/HDL. However, our data provide limited information on specific dosages of PUFAs to guide the clinical treatment of renal replacement therapy patients.

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“…Supplementation with omega-3 fatty acids in only 15 haemodialysis patients in the United States improved the fatty acid profile of erythrocyte membranes by reducing the proportion of saturated fatty acids and increasing the proportion of polyunsaturated fatty acids [ 20 ]. The majority of the other trials in this area have focussed on changes to markers of inflammation and the lipid profile with varying results [ 17 – 19 , 21 , 22 ]. For example, one study reported improvements in inflammatory markers such as IL-6 and TNF-α after supplementation with omega-3 fatty acids [ 18 ], while in another two studies inflammatory markers remained unchanged after supplementation [ 19 , 21 ].…”

Section: Fish Intake and Fish Oilmentioning

confidence: 99%

“…For example, one study reported improvements in inflammatory markers such as IL-6 and TNF-α after supplementation with omega-3 fatty acids [ 18 ], while in another two studies inflammatory markers remained unchanged after supplementation [ 19 , 21 ]. Additionally, supplementation with omega-3 fatty acids has been found to decrease triglyceride levels and increase HDL cholesterol levels [ 17 , 22 ], while another study found that supplementation did not alter triglyceride or total cholesterol levels [ 21 ]. The inconsistencies seen in these trials likely reflect the difficulties in generalising results from small sample sizes, short study durations, and differences in dose of EPA (900 mg to 2010 mg) and DHA (250 mg to 960 mg).…”

Section: Fish Intake and Fish Oilmentioning

confidence: 99%

“…Australia N = 28 (50 % male, 61 ± 17 years) 12-week intervention trial 3000 mg/day n-3 PUFA; (67 % EPA, 17 % DHA) ↓ white cell count, peptide YY; ↑ vascular cell adhesion molecules Gharekhani 2014 [ 19 ]. Iran N = 45 (56 % male); Intervention: n = 25 (57 ± 13 years); Placebo: n = 20 (57 ± 15 years) 4-month RCT 1800 mg/day n-3 PUFA; (60 % EPA, 40 % DHA) ↓ mean serum TIBC; ↑ IL-10/IL-6 ratio; no change: Hb, serum iron, TNFα, CRP Sorensen 2015 [ 22 ]. Denmark N = 161 (65 % male); Intervention: n = 81 (66 ± 11 year); Placebo: n = 80 (68 ± 11 year) 3-month RCT 1700 mg/day n-e PUFA; (45 % EPA, 37.5 % DHA) ↓ TG; ↑ HDL cholesterol; no change: total cholesterol Abbreviations : CI Confidence interval, CRP C-reactive protein, DHA Docosahexaenoic acid, EPA Eicosapentaenoic acid, Hb Haemoglobin content, HDL High density lipoprotein, HR Hazard ratio, IL-6 Interleukin-6, IL-10 Interleukin-10, MI Myocardial infarction, PUFA Polyunsaturated fatty acid, RBC Red blood cell, RCT Randomised controlled trial, TG Triglyceride, TIBC Total iron binding capacity, TNFα Tumour necrosis factor-α …”

Section: Fish Intake and Fish Oilmentioning

confidence: 99%

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Associations of fish oil and vitamin B and E supplementation with cardiovascular outcomes and mortality in people receiving haemodialysis: a review

2015

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BackgroundCardiovascular complications are the leading cause of mortality in patients with end-stage kidney disease. Research indicates that the Mediterranean diet is protective of cardiovascular disease in the general population. Components of this diet have been trialled in haemodialysis patients with the aim of reducing the risk of cardiovascular disease and improving associated risk factors. Components include fish, fruit and vegetables in the form of fish oil supplements and vitamin and antioxidant supplements. This narrative review provides an overview of observational studies, and interventional and randomised controlled trials examining the association of these supplements with cardiovascular outcomes in haemodialysis patients.MethodsWe reviewed the relevant literature by searching English-language publications in Web of Science and references from relevant articles published since 1992. Eight-seven abstracts were reviewed and 38 relevant articles were included.ResultsThe extant literature suggests that risk of mortality is reduced in patients with a higher fish intake and those with higher serum omega-3 fatty acid levels. However, the pathways by which risk of mortality is reduced have not been fully extrapolated. While only a few studies have examined the effect of vitamin B supplementation in haemodialysis patients, these studies suggest that supplementation alone does not reduce the risk of mortality. Finally, studies examining vitamin E supplementation have drawn inconsistent conclusions regarding its pro-oxidant or antioxidant effects. Differences between studies are likely due to methodological variations in regards to dose, route of administration and treatment duration.ConclusionsNutritional and dietary supplementation in haemodialysis patients is an area which requires larger, more methodologically robust randomised controlled trials to determine if risk of cardiovascular outcomes can be improved.

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The Effect of n-3 Fatty Acids on Small Dense Low-Density Lipoproteins in Patients With End-Stage Renal Disease: A Randomized Placebo-Controlled Intervention Study

Cited by 14 publications

References 32 publications

Efficacy of Polyunsaturated Fatty Acids on Inflammatory Markers in Patients Undergoing Dialysis: A Systematic Review with Network Meta-Analysis of Randomized Clinical Trials

Efficacy of Polyunsaturated Fatty Acids on Inflammatory Markers in Patients Undergoing Dialysis: A Systematic Review with Network Meta-Analysis of Randomized Clinical Trials

The Impact of ω-6 and ω-3 fatty acids on lipoproteins in renal replacement therapy patients: A Network Meta-Analysis of Randomized Clinical Trials

Associations of fish oil and vitamin B and E supplementation with cardiovascular outcomes and mortality in people receiving haemodialysis: a review

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