Effects of supplementation with vegetable sources of alpha-linolenic acid (ALA) on inflammatory markers and lipid profile in individuals with chronic kidney disease: A systematic review and meta-analysis

Abstract

Inflammation and dyslipidemia are traditional risk factors and well-known causes of morbidity and mortality in chronic kidney disease (CKD). Alpha-linolenic acid (ALA), an essential fatty acid mainly found in vegetable sources, has been associated with anti-inflammatory effects and improving lipid profile. This systematic review and meta-analysis investigate the effects of supplementation with vegetable sources of ALA on inflammatory marker and lipid profile in individuals with CKD. This review included studies with adult or elderly patients with CKD, including those receiving dialysis, using oral supplementation or food or combined interventions containing vegetable sources of ALA. All studies were randomized trials and The Cochrane Collaboration's tool was use for assessing risk of bias. 19 studies provided data for meta-analyses. ALA had significant effect on reducing C-reactive protein (CRP) after supplementation (WMD:-1.32; 84.5% CI,-2.35 to-0.29, P=0.012), on the other hand, had no significant effect on total cholesterol (WMD:-2.85; 90.1% CI,-14.43 to 8.73, P=0.629), high density lipoprotein (WMD: 1.09; 92.4% CI,-1.82 to 3.99, P=0.463), low density lipoprotein (WMD:-3.87; 86.7% CI,-12.62 to 4.89, P=0.387) and triglycerides (WMD:-16.42; 87.7% CI,-47.83 to 14.98, P=0.305). Vegetables sources of ALA showed beneficial effects on reducing inflammatory marker CRP in CKD patients but had no effect on lipid profile. Future well-designed studies are needed to investigate the effectiveness of vegetables sources of ALA, particularly in CKD.