Lower plasma DHA and EPA and their related oxylipins are potential contributors to vascular disease in hemodialysis patients

Abstract

Hemodialysis patients (HDP) have high blood pressure compared to healthy controls and greater incidence of chronic inflammation, higher C‐reactive protein and risk for cardiovascular disease. Moreover, HDP patients typically demonstrate unusually low plasma n‐3 PUFA levels. The purpose of our investigation was to characterize the oxylipins and endocannabinoids in female HDP (55.5 ± 14.2 y, 8.1± 8.4 y on dialysis) and healthy matched controls (54.8 ± 5 y). Plasma was extracted and subsequently analyzed using ultra performance liquid chromatography followed by electrospray ionization and tandem mass spectrometry for oxylipins and endocannabinoids, while RBC and plasma lipid fatty acids were analyzed by GC. HDP showed lower EPA and family related oxylipids 5‐ and 12‐HEPE and 14–15‐ and 17,18‐DiHETE in plasma compared to controls. The potent n‐3 vasodilators 17(18)–EpETrE and 19(20)‐EpDPE were lower in the HDP compared to the controls raising the possibility that hypertension in HDP could in part be due to reduced peripheral vascular relaxation. Further, the levels of 2‐OG, 1‐LG and 2‐LG were higher in HDP compared to the healthy controls. Herein, we report novel findings on oxylipins and endocannabinoids in female HDP that demonstrate differences compared to controls. This research will provide new opportunities to evaluate the role of dietary PUFA in clinical disease in kidney dialysis patients.