K YONG1,2, T MORI2, G CHEW2, L BEILIN2, I PUDDEY2, G WATTS2, A IRISH2, G DOGRA2,3, N BOUDVILLE2,3, W LIM2,3
1Prince Of Wales Hospital, Randwick, Australia, 2School Of Medicine & Pharmacology, University Of Western Australia, Crawley, Australia, 3Sir Charles Gairdner Hospital, Nedlands, Australia
Aims: To determine whether omega-3 fatty acids (ω3FA) reduce C-reactive protein (CRP) interleukin(IL)-12, IL-18 and improve left ventricular diastolic dysfunction (LVDD) in chronic kidney disease (CKD) patients.
Background: Cardiovascular disease (CVD) remains a leading cause of mortality in CKD patients, with LVDD being a precursor to CVD events. Interventions targeting traditional CVD risk factors have largely proven ineffective in part because of the increased role of non-traditional risk factors such as inflammation in CKD patients. ω3FA are inexpensive and safe natural agents which target inflammation and oxidative stress. However, their effect upon inflammation and LVDD in CKD patients remains unknown.
Methods: This was a post-hoc analysis of a double-blinded randomised placebo-controlled trial of ω3FA (4g-daily for 8 weeks) in 70 non-diabetic participants with stage 3-4 CKD. LVDD, IL-12, IL-18, and CRP were measured pre- and post-intervention. LVDD was defined as grade I, II and III as per the American Society of Echocardiography. Linear mixed models and chi-square were used to compare between-group differences in inflammatory markers and LVDD respectively. Independent t-test was used to compare intra-group differences pre- and post-intervention.
Results: The ω3FA (n=36) and placebo (n=34) groups had similar age (mean±SE; 55.6±2.5vs56.3±2.5yrs; p=0.8] and prevalent CVD (11%vs12%; p=0.6). Pre- and post-intervention LVDD, IL-12, IL-18 and hsCRP were similar between groups. Mean change in IL-18 was significantly less with ω3FA (24±14pg/mL) compared to placebo (65±14pg/mL; p=0.04). Severe LVDD (grade II/III) increased from 60% to 90% with placebo compared to 65% to 80% with ω3FA over the study period.
Conclusion: Short-term high-dose ω3FA supplementation may attenuate inflammation but larger studies with longer duration are required to clarify if ω3FA have beneficial effects upon surrogate CVD markers.
Kenneth Yong is a nephrologist staff specialist at the Prince Of Wales Hospital, Randwick Sydney. He is currently completing his higher degree and has interests in cardiovascular medicine, vasculitis and renal transplantation.