Abstract
BackgroundPatients with chronic kidney disease have a markedly increased cardiovascular mortality compared with the general population. Long chain n-3 polyunsaturated fatty acids have been suggested to possess cardioprotective properties. This cross-sectional and comparative study evaluated correlations between hemodynamic measurements, resistance artery function and fish consumption to the content of long chain n-3 polyunsaturated fatty acids in adipose tissue, a long-term marker of seafood intake.MethodsSeventeen patients with chronic kidney disease stage 5 + 5d and 27 healthy kidney donors were evaluated with hemodynamic measurements before surgery; from these subjects, 11 patients and 11 healthy subjects had vasodilator properties of subcutaneous resistance arteries examined. The measurements were correlated to adipose tissue n-3 polyunsaturated fatty acids. Information on fish intake was obtained from a dietary questionnaire and compared with adipose tissue n-3 polyunsaturated fatty acids.ResultsFish intake and the content of n-3 polyunsaturated fatty acids in adipose tissue did not differ between patients and controls. n-3 polyunsaturated fatty acid levels in adipose tissue were positively correlated to systemic vascular resistance index; (r = 0.44; p = 0.07 and r = 0.62; p < 0.05, chronic kidney disease and healthy subjects respectively) and negatively correlated to cardiac output index (r = −0.69; p < 0.01 and r = −0.50; p < 0.05, chronic kidney disease and healthy subjects respectively). No correlation was observed between n-3 polyunsaturated fatty acid levels in adipose tissue and vasodilator properties in resistance arteries. n-3 PUFA content in adipose tissue increased with increasing self-reported fish intake.ConclusionsThe correlations found, suggest a role for n-3 polyunsaturated fatty acids in hemodynamic properties. However, this is apparently not due to changes in intrinsic properties of the resistance arteries as no correlation was found to n-3 polyunsaturated fatty acids.
Highlights
Patients with chronic kidney disease have a markedly increased cardiovascular mortality compared with the general population
Content of long chain n-3 polyunsaturated fatty acids (PUFA) in adipose tissue were comparable between chronic kidney disease (CKD) patients and healthy subjects (CKD 0.25 ± 0.18%, n = 17 vs. healthy controls 0.29 ± 0.21%, n = 23)
pulse wave velocity (PWV) was higher in CKD patients (CKD 9.53 ± 4.08 m/s, n = 15 vs. 7.24 ± 1.46 m/s, n = 25; p < 0.05), augmentation index was lower in CKD patients (CKD 70.5 ± 22.6%, n = 15 vs. healthy subjects 86.3 ± 17.5%, n = 25; p < 0.01) while cardiac output index and Systemic vascular resistance index (SVRi) did not differ significantly between CKD patients and healthy subjects
Summary
Patients with chronic kidney disease have a markedly increased cardiovascular mortality compared with the general population. Patients with chronic kidney disease (CKD) have a high risk of cardiovascular disease (CVD) compared with the general population and with declining renal function, the risk of CVD increases [1]. Cardiovascular mortality has been reduced substantially during the past years, but in patients with CKD the high mortality from CVD remains unchanged [2]. The mechanisms responsible for the accelerated atherosclerosis in CKD are somewhat distinct from patients with classic CVD with intima lesions. They include inflammatory processes leading to vascular and myocardial fibrosis and vascular media calcifications [3, 4]. As estimated by either pulse wave velocity (PWV) or augmentation index, has proved to be an independent predictor of CVD in patients with CKD [6]
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