The effect of fish oil on inflammation markers in adult patients undergoing hemodialysis: A meta-analysis.

Abstract

This meta-analysis was to assess the effect of fish oil supplementation on inflammation markers in adult patients receiving hemodialysis. CENTRAL, EMBASE, MEDLINE databases were searched from inception to 10 April 2020. Two authors independently searched, selected, and screened the literature. The pooled results are represented by WMD or SMD with 95% confidence intervals. Subgroup analysis and meta-regression were used to explore sources of heterogeneity, and sensitivity analysis was used to assess the robustness of the pooled results. Funnel plots were used to assess publication bias. Eleven RCT (randomized control trials) studies were included. The pooled results showed that fish oil supplementation caused a significant reduction of the CRP(C-reactive protein) level (random model: WMD, -3.36, 95%CI: -5.46 to -1.26, P= .002), especially in patients with baseline CRP ≥5mg/L (random model: WMD, -4.43, 95%CI: -6.10 to -2.76, P= .00001, I2 = 41%). Meta-regression analyses showed that CRP baseline level (CRP <5mg/L) was the main source of heterogeneity (P= .036). Sensitive analyses revealed that the result was hardly changed. Fish oil supplementation might not reduce the level of IL-6 (random model: WMD, -2.26, 95%CI: -19.61 to 15.09, P= .80) in four studies or the level of TNF-α (random model: SMD, -2.51, 95%CI: -6.08 to 1.06, P= .17) in three studies. Fish oil supplementation could reduce the level of CRP in hemodialysis patients, especially in patients with CRP ≥5mg/L, but had no effects on IL-6 and TNF-α.