期刊论文详细信息
BMC Nephrology
Associations of fish oil and vitamin B and E supplementation with cardiovascular outcomes and mortality in people receiving haemodialysis: a review
Charlotte McKercher2  Matthew D. Jose1  Erica Bessell2 
[1]School of Medicine, University of Tasmania, Hobart 7000, Tasmania, Australia
[2]Menzies Institute for Medical Research, University of Tasmania, Hobart 7000, Tasmania, Australia
关键词: Vitamins;    Omega-3 fatty acids;    Haemodialysis;    Fish oil;    End-stage kidney disease;    Cardiovascular disease;    Antioxidants;   
Others  :  1223605
DOI  :  10.1186/s12882-015-0142-1
 received in 2015-04-20, accepted in 2015-08-06,  发布年份 2015
PDF
【 摘 要 】

Background

Cardiovascular complications are the leading cause of mortality in patients with end-stage kidney disease. Research indicates that the Mediterranean diet is protective of cardiovascular disease in the general population. Components of this diet have been trialled in haemodialysis patients with the aim of reducing the risk of cardiovascular disease and improving associated risk factors. Components include fish, fruit and vegetables in the form of fish oil supplements and vitamin and antioxidant supplements. This narrative review provides an overview of observational studies, and interventional and randomised controlled trials examining the association of these supplements with cardiovascular outcomes in haemodialysis patients.

Methods

We reviewed the relevant literature by searching English-language publications in Web of Science and references from relevant articles published since 1992. Eight-seven abstracts were reviewed and 38 relevant articles were included.

Results

The extant literature suggests that risk of mortality is reduced in patients with a higher fish intake and those with higher serum omega-3 fatty acid levels. However, the pathways by which risk of mortality is reduced have not been fully extrapolated. While only a few studies have examined the effect of vitamin B supplementation in haemodialysis patients, these studies suggest that supplementation alone does not reduce the risk of mortality. Finally, studies examining vitamin E supplementation have drawn inconsistent conclusions regarding its pro-oxidant or antioxidant effects. Differences between studies are likely due to methodological variations in regards to dose, route of administration and treatment duration.

Conclusions

Nutritional and dietary supplementation in haemodialysis patients is an area which requires larger, more methodologically robust randomised controlled trials to determine if risk of cardiovascular outcomes can be improved.

【 授权许可】

   
2015 Bessell et al.

【 预 览 】
附件列表
Files Size Format View
20150903024928583.pdf 427KB PDF download
【 参考文献 】
  • [1]Rees K, Dyakova M, Ward K, Thorogood M, Brunner E. Dietary advice for reducing cardiovascular risk. Cochrane Database Syst Rev. 2013; 3: Article ID CD002128
  • [2]Rees K, Hartley L, Flowers N, Clarke A, Hooper L, Thorogood M et al.. ‘Mediterranean’ dietary pattern for the primary prevention of cardiovascular disease. Cochrane Database Syst Rev. 2013; 8: Article ID CD009825
  • [3]Martinez-Gonzalez MA, Bes-Rastrollo M. Dietary patterns, Mediterranean diet, and cardiovascular disease. Curr Opin Lipidol. 2014; 25:20-6.
  • [4]Grosso G, Mistretta A, Frigiola A, Gruttadauria S, Biondi A, Basile F et al.. Mediterranean diet and cardiovascular risk factors: a systematic review. Crit Rev Food Sci Nutr. 2014; 54:593-610.
  • [5]Svensson M, Schmidt EB, Jorgensen KA, Christensen JH. N-3 fatty acids as secondary prevention against cardiovascular events in patients who undergo chronic hemodialysis: a randomized, placebo-controlled intervention trial. Clin J Am Soc Nephrol. 2006; 1:780-6.
  • [6]Kamgar M, Zaldivar F, Vaziri ND, Pahl MV. Antioxidant therapy does not ameliorate oxidative stress and inflammation in patients with end-stage renal disease. J Natl Med Assoc. 2009; 101:336-44.
  • [7]Holden RM, Ki V, Morton AR, Clase C. Fat-soluble vitamins in advanced CKD/ESKD: a review. Semin Dial. 2012; 25:334-43.
  • [8]Friedman A, Moe S. Review of the effects of omega-3 supplementation in dialysis patients. Clin J Am Soc Nephrol. 2006; 1:182-92.
  • [9]Fish, fish oils, n-3 polyunsaturated fatty acids and cardiovascular health. National Heart Foundation of Australia, Melbourne; 2008.
  • [10]Kutner NG, Clow PW, Zhang R, Aviles X. Association of fish intake and survival in a cohort of incident dialysis patients. Am J Kidney Dis. 2002; 39:1018-24.
  • [11]Noori N, Dukkipati R, Kovesdy CP, Sim JJ, Feroze U, Murali SB et al.. Dietary omega-3 fatty acid, ratio of omega-6 to omega-3 intake, inflammation, and survival in long-term hemodialysis patients. Am J Kidney Dis. 2011; 58:248-56.
  • [12]Friedman AN, Saha C, Watkins BA. Feasibility study of erythrocyte long-chain omega-3 polyunsaturated fatty acid content and mortality risk in hemodialysis patients. J Ren Nutr. 2008; 18:509-12.
  • [13]Hamazaki K, Terashima Y, Itomura M, Sawazaki S, Inagaki H, Kuroda M et al.. Docosahexaenoic acid is an independent predictor of all-cause mortality in hemodialysis patients. Am J Nephrol. 2011; 33:105-10.
  • [14]Terashima Y, Hamazaki K, Itomura M, Tomita S, Kuroda M, Hirata H et al.. Inverse association between docosahexaenoic acid and mortality in patients on hemodialysis during over 10 years. Hemodial Int. 2014; 18:625-31.
  • [15]Shoji T, Kakiya R, Hayashi T, Tsujimoto Y, Sonoda M, Shima H et al.. Serum n-3 and n-6 polyunsaturated fatty acid profile as an independent predictor of cardiovascular events in hemodialysis patients. Am J Kidney Dis. 2013; 62:568-76.
  • [16]Friedman AN, Yu Z, Tabbey R, Denski C, Tamez H, Wenger J et al.. Inverse relationship between long-chain n-3 fatty acids and risk of sudden cardiac death in patients starting hemodialysis. Kidney Int. 2013; 83:1130-5.
  • [17]Svensson M, Schrnidt EB, Jorgensen KA, Christensen JH. The effect of n-3 fatty acids on lipids and lipoproteins in patients treated with chronic haemodialysis: a randomized placebo-controlled intervention study. Nephrol Dial Transplant. 2008; 23:2918-24.
  • [18]Perunicic-Pekovic GB, Rasic ZR, Pljesa SI, Sobajic SS, Djuricic I, Maletic R et al.. Effect of n-3 fatty acids on nutritional status and inflammatory markers in haemodialysis patients. Nephrology (Carlton). 2007; 12:331-6.
  • [19]Gharekhani A, Khatami MR, Dashti-Khavidaki S, Razeghi E, Noorbala AA, Hashemi-Nazari SS et al.. The effect of omega-3 fatty acids on depressive symptoms and inflammatory markers in maintenance hemodialysis patients: a randomized, placebo-controlled clinical trial. Eur J Clin Pharmacol. 2014; 70:655-65.
  • [20]Saifullah A, Watkins BA, Saha C, Li Y, Moe SM, Friedman AN. Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients- a pilot study. Nephrol Dial Transplant. 2007; 22:3561-7.
  • [21]Vernaglione L, Cristofano C, Chimienti S. Omega-3 polyunsaturated fatty acids and proxies of cardiovascular disease in hemodialysis: a prospective cohort study. J Nephrol. 2008; 21:99-105.
  • [22]Sorensen GV, Svensson M, Strandhave C, Schmidt EB, Jorgensen KA, Christensen JH. The effect of n-3 fatty acids on small dense low-density lipoproteins in patients with end-stage renal disease: a randomized placebo-controlled intervention study. J Ren Nutr. 2015; 25:376-80.
  • [23]Nestel P, Clifton P, Colquhoun D, Noakes M, Mori TA, Sullivan D, et al. Indications for omega-3 long chain polyunsaturated fatty acid in the prevention and treatment of cardiovascular disease. Heart Lung Circ. 2015; doi:. 10. 1016/j.hlc.2015.03.020 webcite
  • [24]Kirkegaard E, Svensson M, Strandhave C, Schmidt EB, Jorgensen KA, Christensen JH. Marine n-3 fatty acids, atrial fibrillation and QT interval in haemodialysis patients. Br J Nutr. 2012; 107:903-9.
  • [25]Fortmann SP, Burda BU, Senger CA, Lin JS, Whitlock EP. Vitamin and mineral supplements in the primary prevention of cardiovascular disease and cancer: an updated systematic evidence review for the U.S. Preventative Services Task Force. Ann Intern Med. 2013; 159:824-34.
  • [26]Spormann TM, Albert FW, Rath T, Dietrich H, Will F, Stockis JP et al.. Anthocyanin/polyphenolic-rich fruit juice reduces oxidative cell damage in an intervention study with patients on hemodialysis. Cancer Epidemiol Biomarkers Prev. 2008; 17:3372-80.
  • [27]Himmelfarb J, Phinney S, Ikizler TA, Kane J, McMonagle E, Miller G. Gamma-tocopherol and docosahexaenoic acid decrease inflammation in dialysis patients. J Ren Nutr. 2007; 17:296-304.
  • [28]Lu L, Erhard P, Salomon RG, Weiss MF. Serum vitamin E and oxidative protein modification in hemodialysis: a randomized clinical trial. Am J Kidney Dis. 2007; 50:305-13.
  • [29]Smith KS, Lee CL, Ridlington JW, Leonard SW, Devaraj S, Traber MG. Vitamin E supplementation increases circulating vitamin E metabolites tenfold in end-stage renal disease patients. Lipids. 2003; 38:813-9.
  • [30]Antoniadi G, Eleftheriadis T, Liakopoulos V, Kakasi E, Kartsios C, Passadakis P et al.. Effect of one-year oral alpha-tocopherol administration on the antioxidant defense system in hemodialysis patients. Ther Apher Dial. 2008; 12:237-42.
  • [31]Boaz M, Smetana S, Weinstein T, Matas Z, Gafter U, Iaina A et al.. Secondary prevention with antioxidants of cardiovascular disease in endstage renal disease (SPACE): randomised placebo-controlled trial. Lancet. 2000; 356:1213-8.
  • [32]Espe KM, Raila J, Henze A, Blouin K, Schneider A, Schmiedeke D et al.. Low plasma alpha-tocopherol concentrations and adverse clinical outcomes in diabetic hemodialysis patients. Clin J Am Soc Nephrol. 2013; 8:452-8.
  • [33]Heinz J, Kropf S, Domrose U, Westphal S, Borucki K, Luley C et al.. B vitamins and the risk of total mortality and cardiovascular disease in end-stage renal disease- results of a randomized controlled trial. Circulation. 2010; 121:1432-8.
  • [34]Jamison RL, Hartigan P, Kaufman JS, Goldfarb DS, Warren SR, Guarino PD et al.. Effect of homocysteine lowering on mortality and vascular disease in advanced chronic kidney disease and end-stage renal disease - a randomized controlled trial. JAMA. 2007; 298:1163-70.
  • [35]Leung J, Larive B, Dwyer J, Hibberd P, Jacques P, Rand W et al.. Folic acid supplementation and cardiac and stroke mortality among hemodialysis patients. J Ren Nutr. 2010; 20:293-302.
  • [36]Wanner C, Krane V, Marz W, Olschewski M, Mann JF, Ruf G et al.. Atorvastatin in patients with type 2 diabetes mellitus undergoing hemodialysis. N Engl J Med. 2005; 353:238-48.
  • [37]Fellstrom BC, Jardine AG, Schmieder RE, Holdaas H, Bannister K, Beutler J et al.. Rosuvastatin and cardiovascular events in patients undergoing hemodialysis. N Engl J Med. 2009; 360:1395-407.
  • [38]Zabel R, Ash S, King N, Naslund E, Bauer J. Gender differences in the effect of fish oil on appetite, inflammation and nutritional status in haemodialysis patients. J Hum Nutr Diet. 2010; 23:416-25.
  文献评价指标  
  下载次数:2次 浏览次数:8次