Fish consumption and omega-3 fatty acid status and determinants in long-term hemodialysis.Am J Kidney Dis. 2006 Jun; 47(6):1064-71.AJ
Blood levels of the anti-inflammatory and cardioprotective omega-3 eicosapentaenoic (EPA) and docosahexaenoic (DHA) fatty acids are determined primarily by dietary consumption. There is reason to believe that hemodialysis patients are at risk for inadequate omega-3 intake and, consequently, low blood levels.
This question was tested in 75 long-term hemodialysis patients and 25 matched controls by measuring fasting, predialysis plasma and red blood cell (RBC) fatty acid levels using gas chromatography and performing a fish-consumption survey.
Sixty-seven percent of patients did not meet American Heart Association fish-consumption guidelines for healthy persons. Compared with controls, patients had lower plasma omega-3 levels (mean % wt: DHA, 1.33 +/- 0.38 [SD] versus 1.51 +/- 0.36; P = 0.0370; omega-3 index [ie, EPA plus DHA], 1.67 +/- 0.49 versus 1.92 +/- 0.40; P = 0.0249). RBC levels, which estimate more long-term consumption, showed mixed results (EPA, 0.29 +/- 0.08 versus 0.33 +/- 0.11; P = 0.0816; DHA, 4.65 +/- 0.92 versus 3.16 +/- 1.15; P < 0.0001; omega-3 index, 4.95 +/- 0.95 versus 3.49 +/- 1.22; P < 0.0001). RBC omega-3 levels in patients roughly reflected fish consumption. Independent predictors of plasma and RBC omega-3 levels at the 0.05 level of significance included age, race, sex, alcohol use, and fish servings.
Hemodialysis patients consumed fish in quantities far below current American Heart Association recommendations and manifested suboptimal omega-3 levels given their high heart disease risk. These results identify a potentially modifiable cardiovascular risk factor.