Assessment of the role of polyunsaturated fatty acids in chronic kidney disease

ABSTRACT

Recent evidence suggests a relationship between abnormalities of polyunsaturated fatty acids [PUFAs] and the development of chronic kidney disease [CKD].To assess plasma concentration levels of n-6 PUFAs in CKD patients to clarify their role in the development and progression of the kidney disease in an attempt to provide an early protective therapeutic strategy. Fifty eight CKD patients as well as thirty healthy controls were enrolled and subjected to thorough clinical assessment and laboratory investigations including kidney function tests [serum urea, creatinine, total proteins and albumin], lipid profile [total cholesterol, triglycerides, high density lipoprotein-cholesterol [HDL-C], low density lipoprotein-cholesterol [LDL-C] and atherosclerotic risk ratio [T-Cholesterol/HDL-C]] in addition to analysis of PUFAs of the n-6 series which include linoleic, gamma-linolenic and arachidonic acids by high performance liquid chromatography [HPLC]. A highly significant decrease of gamma-linolenic and arachidonic acids was detected in CKD patients as compared to controls, while linoleic acid was elevated in CKD patients, however this elevation was statistically insignificant when compared to the control group. The correlation study showed that each of gamma-linolenic acid and arachidonic acid were significantly positively correlated with creatinine clearance and HDL-C and significantly negatively correlated with triglycerides, LDL-C and risk ratio. Meanwhile, linoleic acid showed a significant positive correlation with triglycerides and insignificant correlations with creatinine clearance, total cholesterol, HDL-C, LDL-C and risk ratio. The long chain n-6 fatty acids gamma-linolenic and arachidonic acids are present in insufficient amounts in plasma of CKD patients and such insufficiency increases with the severity of the kidney disease confirming the role of impaired n-6 PUFAs metabolism in the development and progression of CKD. Thus, high dietary intake of n-6 fatty acids [mainly gamma-linolenic acid] could be recommended as a new therapeutic strategy in CKD patients aiming at interrupting the irreversible process of renal fibrosis and ameliorating chronic renal injury and may also be protective against the development of cardiovascular disease among those patients