Effects of Omega-3 Fatty Acid Intake in Patients Undergoing Dialysis: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

J Am Nutr Assoc. 2022 Sep-Oct;41(7):697-712. doi: 10.1080/07315724.2021.1953416. Epub 2021 Oct 11.

Abstract

Objective: Fish oil supplementation has been shown to be beneficial for hemodialysis (HD) patients. The aim of this study was to evaluate the efficacy and safety of omega-3 fatty acid supplementation or dietary adjustment in dialysis patients.Methods: A systematic literature search was performed to identify relevant randomized controlled trials (RCTs) to study the effects of omega-3 supplementation on dialysis patients. The variables of interest included the levels of blood lipids, inflammatory indicators, proteins, parathyroid hormone (PTH), gastrointestinal adverse reactions, and all-cause mortality. The mean differences (MDs) and 95% confidence intervals (CIs) were calculated, and heterogeneity was assessed with the I2 test. Subgroup and sensitivity analyses were performed to identify potential sources.Results: The systematic review included 49 RCTs and evaluated the efficacy and safety of omega-3 fatty acid supplementation in dialysis patients. Data synthesis showed that compared with the control group, the group receivingomega-3 supplementation exhibited significantly decreased serum triglyceride (TG) levels, decreased C-reactive protein (CRP) and TNF-alpha levels, increased hemoglobin levels, reduced serum phosphorus levels, increased PTH levels, and increased gastrointestinal adverse reactions to a certain extent. Furthermore, there was no effect on the blood total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), albumin or calcium levels and all-cause mortality.Conclusion: Omega-3 fatty acid supplementation is related to a reduction in serum TG, LDL and inflammation index levels and has few adverse reactions. Therefore, omega-3 fatty acid supplementation may be a useful nutrition therapy for dialysis patients.

Keywords: Dialysis; efficacy; meta-analysis; nutrition; omega-3 fatty acid.

Publication types

  • Meta-Analysis
  • Systematic Review
  • Research Support, Non-U.S. Gov't

MeSH terms

  • C-Reactive Protein
  • Calcium
  • Cholesterol, LDL
  • Dietary Supplements / adverse effects
  • Fatty Acids, Omega-3* / adverse effects
  • Fish Oils
  • Hemoglobins
  • Parathyroid Hormone
  • Phosphorus
  • Randomized Controlled Trials as Topic
  • Renal Dialysis* / adverse effects
  • Triglycerides
  • Tumor Necrosis Factor-alpha

Substances

  • Cholesterol, LDL
  • Fatty Acids, Omega-3
  • Fish Oils
  • Hemoglobins
  • Parathyroid Hormone
  • Triglycerides
  • Tumor Necrosis Factor-alpha
  • Phosphorus
  • C-Reactive Protein
  • Calcium