N-3 polyunsaturated fatty acids, lipids and lipoproteins in end-stage renal disease

Abstract

The increased mortality in end-stage renal disease (ESRD) is mainly caused by cardiovascular disease (CVD). Several risk factors for CVD are present in patients with ESRD, including a mixed dyslipidemia, specific for the uremic state. Randomized controlled trials in patients with ESRD are sparse and some cholesterol-lowering randomized controlled trials have had negative results. Both epidemiological and interventional data support a cardioprotective effect of an increased intake of n-3 polyunsaturated fatty acids (n-3 PUFA). Several mechanisms could explain why n-3 PUFA have a beneficial effect on patients with CVD. Thus, the effects on lipids and triglycerides are especially well described. In patients with ESRD the effect of n-3 PUFA has only been sparsely studied. This article will provide an update on existing data concerning treatment with n-3 PUFA in patients with ESRD with a special focus on lipids and lipoproteins.