Abstract
The effect of marine-derived omega-3 polyunsaturated fatty acids (n-3 PUFA) on long-term outcome in renal transplant recipients (RTR) remains unclear. We investigated whether marine-derived n-3 PUFA intake is associated with all-cause and cardiovascular (CV) mortality in RTR. Intake of eicosapentaenoic acid plus docosahexaenoic acid (EPA-DHA) was assessed using a validated Food Frequency Questionnaire. Cox regression analyses were performed to evaluate the associations of EPA-DHA intake with all-cause and CV mortality. We included 627 RTR (age 53 ± 13 years). EPA-DHA intake was 102 (42–215) mg/day. During median follow-up of 5.4 years, 130 (21%) RTR died, with 52 (8.3%) due to CV causes. EPA-DHA intake was associated with lower risk of all-cause mortality (Hazard Ratio (HR) 0.85; 95% confidence interval (95% CI) 0.75–0.97). Age (p = 0.03) and smoking status (p = 0.01) significantly modified this association, with lower risk of all-cause and CV mortality particularly in older (HR 0.75, 95% CI 0.61–0.92; HR 0.68, 95% CI 0.48–0.95) and non-smoking RTR (HR 0.80, 95% CI 0.68–0.93; HR 0.74, 95% CI 0.56–0.98). In conclusion, marine-derived n-3 PUFA intake is inversely associated with risk of all-cause and CV mortality in RTR. The strongest associations were present in subgroups of patients, which adds further evidence to the plea for EPA-DHA supplementation, particularly in elderly and non-smoking RTR.
Highlights
Renal transplantation offers superior survival, quality of life, and cost-effectiveness in comparison with chronic dialysis treatment [1,2,3,4,5,6,7,8]
eicosapentaenoic acid plus docosahexaenoic acid (EPA-DHA) intake was associated with lower risk of all-cause mortality (Model 2: Hazard ratios (HR) 0.85; 95% confidence interval (95% confidence interval (CI)) 0.75–0.97, p = 0.02) independent of potential confounders including age, sex, estimated glomerular filtration rate (eGFR), proteinuria, and time between transplantation and baseline
The association of EPA-DHA intake with CV mortality was of similar magnitude, but did not reach statistical significance (Model 2: HR 0.83, 95% CI 0.68–1.02, p = 0.08)
Summary
Renal transplantation offers superior survival, quality of life, and cost-effectiveness in comparison with chronic dialysis treatment [1,2,3,4,5,6,7,8]. It is considered the “gold standard” treatment for most patients with end-stage renal disease. The consumption of polyunsaturated fatty acids may reduce the CV risk profile. Several countries and organizations such as the World Health Organization have made population-based diet recommendations for omega-3 polyunsaturated fatty acids (n-3 PUFA) intake.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
