Omega-3 Fatty Acid Supplementation is Associated With Oxidative Stress and Dyslipidemia, but Does not Contribute to Better Lipid and Oxidative Status on Hemodialysis Patients.

OBJECTIVE: The aim of the study was to explore the effects of n-3 polyunsaturated fatty acids (PUFA) supplementation in physiological doses on oxidative stress (OS) and dyslipidemia in patients on hemodialysis (HD). DESIGN AND METHODS: Randomized, double-blind, controlled, experimental trial. A total of 88 HD patients ≥18 years old and on HD for at least 6 months. A total of 43 patients received 1.28 g/day of n-3 PUFA, and 45 other patients received soybean oil for 12 weeks. Both oil supplements were vitamin E standardized. Routine tests, lipid profile, advanced oxidation protein products, isoprostanes, vitamins C and E, total antioxidant capacity, serum fatty acids, and adverse effects were evaluated. RESULTS: Supplementation was not able to alter lipid or OS profiles. There was an increase in the serum n-3 PUFA levels (eicosapentaenoic acid: +116%; docosahexaenoic acid: +100%) and an improvement in the n-6/n-3 ratio (-49%) in the supplemented group. Associations between n-3 PUFA and improvement in isoprostane and advanced oxidation protein product and HDL were observed. Treatment was well tolerated. CONCLUSION: Although the n-3 PUFA supplementation was associated with lower concentrations of isoprostane and advanced oxidation protein product and higher HDL levels, it was not sufficient for the improvement of highly prevalent risk factors, such as OS and dyslipidemia in HD patients.

Association of body fat with inflammation in peritoneal dialysis.

Peritoneal dialysis (PD) frequently leads to body weight gain, which appears to be a potential cause of the chronic inflammation frequently present in these patients. The consequences of this inflammation are impaired nutritional status, accelerated atherosclerosis, and increased mortality. To assess the association between inflammation and body fat in female patients treated with PD. Nineteen female patients on PD for at least 6 months with no infectious complications or malignant or acute inflammatory diseases. Nutritional status was determined by measuring weight, height, body mass index (BMI), waist (WC), and mid-arm circumferences (MAC), mid-arm muscle area, and tricipital fold (TCF). Bioelectrical impedance (BIA) was used to determine body composition. Biochemical evaluation included the determination of serum albumin, urea, creatinine, and C-reactive protein (CRP). The glucose absorbed from the dialysis solution was quantitated. According to BMI, two patients were classified as malnourished and ten as overweight/obese. Sixteen individuals had high WC measurements and 12 had excess body fat (BF) as measured by BIA. High CRP levels were observed in 12 patients, who had higher WC, MAC, BMI, TCF, and BF measurements compared to non-inflamed patients. Positive associations were detected between CRP and BMI, MAC, WC, and TCF. Associations between BF and CRP suggest that adiposity may be a potent exacerbating factor of inflammation in this population, especially visceral fat. Thus, obesity may be considered to be one more factor responsible for the early atherosclerosis and high cardiovascular mortality observed in these patients.