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American Journal of Kidney Diseases

Omega-3 Polyunsaturated Fatty Acids in the Treatment of Kidney Disease

  • Robert G. Fassett
    Correspondence
    Address correspondence to Robert G. Fassett, MD, PhD, Renal Research, Level 9 Ned Hanlon Bldg, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia 4029
    Affiliations
    Renal Research, Royal Brisbane and Women's Hospital, Brisbane, Queensland, Australia

    University of Queensland, School of Human Movement Studies, Brisbane, Queensland, Australia

    University of Queensland, Centre for Kidney Disease Research, School of Medicine, Brisbane, Queensland, Australia
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  • Glenda C. Gobe
    Affiliations
    University of Queensland, Centre for Kidney Disease Research, School of Medicine, Brisbane, Queensland, Australia
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  • Jonathan M. Peake
    Affiliations
    University of Queensland, School of Human Movement Studies, Brisbane, Queensland, Australia

    University of Queensland, Centre for Military and Veterans' Health, Brisbane, Queensland, Australia
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  • Jeff S. Coombes
    Affiliations
    University of Queensland, School of Human Movement Studies, Brisbane, Queensland, Australia
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      After more than 25 years of published investigation, including randomized controlled trials, the role of omega-3 polyunsaturated fatty acids in the treatment of kidney disease remains unclear. In vitro and in vivo experimental studies support the efficacy of omega-3 polyunsaturated fatty acids on inflammatory pathways involved with the progression of kidney disease. Clinical investigations have focused predominantly on immunoglobulin A (IgA) nephropathy. More recently, lupus nephritis, polycystic kidney disease, and other glomerular diseases have been investigated. Clinical trials have shown conflicting results for the efficacy of omega-3 polyunsaturated fatty acids in IgA nephropathy, which may relate to varying doses, proportions of eicosapentaenoic acid and docosahexaenoic acid, duration of therapy, and sample size of the study populations. Meta-analyses of clinical trials using omega-3 polyunsaturated fatty acids in IgA nephropathy have been limited by the quality of available studies. However, guidelines suggest that omega-3 polyunsaturated fatty acids should be considered in progressive IgA nephropathy. Omega-3 polyunsaturated fatty acids decrease blood pressure, a known accelerant of kidney disease progression. Well-designed, adequately powered, randomized, controlled clinical trials are required to further investigate the potential benefits of omega-3 polyunsaturated fatty acids on the progression of kidney disease and patient survival.

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      Linked Article

      • Omega-3 Polyunsaturated Fatty Acids and Clinical Trials
        American Journal of Kidney DiseasesVol. 57Issue 2
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          In an interesting review, Fassett et al1 mention several mechanisms by which omega-3 polyunsaturated fatty acids might benefit patients with kidney disease. Among these mechanisms are antithrombotic and lipid-modulating effects. We draw attention to studies that might be relevant to discuss in this context.
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      • Polyunsaturated Fatty Acids and Kidney Disease
        American Journal of Kidney DiseasesVol. 57Issue 2
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          I have read with interest the recent review by Fassett et al.1 However, I disagree with the statement the investigators made after reporting the main findings of our study of polyunsaturated fatty acids in immunoglobulin A nephropathy.2 According to them, results of our trial would be limited by the different baseline kidney function in the experimental and control groups. As we reported in our article, differences in estimated baseline glomerular filtration rates (GFRs) between the 2 groups were not statistically significant (P = 0.232).
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