Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients--a pilot study.
What this study found
Fish oil was well tolerated and clearly increased blood omega-3 status while improving inflammation markers. In the fish oil group, erythrocyte EPA rose from 0.2 ± 0.1 to 1.0 ± 0.5, erythrocyte DHA from 1.9 ± 1.1 to 5.8 ± 2.2, and the omega-3 index from 2.1 ± 1.1 to 6.8 ± 2.6, all with P < 0.01. Plasma CRP fell from 13.8 ± 13.8 mg/L to 10.5 ± 12.7 mg/L (P = 0.03), and triglycerides decreased from 140 ± 127 mg/dl to 116 ± 71 mg/dl with a nonsignificant trend (P = 0.08). Coagulation, glucose, LDL, HDL, and albumin were not adversely affected.
- Study & population
- Pilot randomized placebo-controlled trial in adults aged 18 years or older receiving maintenance haemodialysis in an urban American population in Indianapolis, Indiana.
- Intervention
- The active intervention was oral fish oil capsules providing 1.3 g/day of EPA plus DHA, taken as two capsules daily for 12 weeks.
- Key limitation
- This was a small pilot study with only 15 analyzed participants in the active arm and a short 12-week duration, which limits precision and clinical interpretation.
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Open PDFOriginal abstract
BACKGROUND We previously reported that haemodialysis patients have suboptimal blood levels of the cardioprotective omega-3 polyunsaturated fatty acids (n-3 PUFA) eicosapentaenoic (EPA) and docosahexaenoic (DHA) acids. In the present pilot study, we tested the hypothesis that supplementing haemodialysis patients for 12 weeks with the American Heart Association (AHA)-recommended fish oil dose would be well tolerated and efficacious in boosting blood n-3 PUFA levels and improving cardiovascular risk biomarkers. METHODS Twenty-seven subjects were randomized in a 2 : 1 ratio to either 1.3 g of EPA + DHA daily or placebo. RESULTS At baseline, 83% of subjects consumed inadequate dietary fish and had the following erythrocyte n-3 PUFA levels (mean +/- SD,% weight)-EPA: 0.3 +/- 0.2, DHA: 2.9 +/- 2.0, and ratio of n-6/n-3 PUFA: 4.2 +/- 1.3. Supplementation induced large increases in mean blood EPA and DHA levels (% increase, P-value vs placebo group): erythrocyte-EPA: +400%, P = 0.0018, DHA: +205%, P < 0.0001; plasma-EPA: +275%, P = 0.0003, DHA: +69%, P = 0.0352. Levels in the placebo group remained relatively unchanged. The omega-3 index, a value correlating with the level of cardioprotection, increased significantly in the fish oil group. A reduction in mean C-reactive protein levels (-3.3 +/- 8.1 mg/l, P = 0.0282) and a trend towards lower triglyceride levels (-24 +/- 74 mg/dl, P = 0.0783) were also observed in the active vs placebo group. Minimal side effects were noted. CONCLUSIONS Our preliminary observations that the AHA-recommended fish oil dose is well tolerated, efficacious and may improve surrogate markers of cardiovascular disease in haemodialysis patients paves the way for larger clinical trials to confirm a clinical benefit.