Association of Consumption of Omega 3 Polyunsaturated Fatty Acids with Incident CKD

Post on April 3, 2023 by André Broussard, D.C.

April 03, 2023
BMJ : British Medical Journal

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  • This pooled analysis examining more than 25,000 patients found a modest but significant reduction in the rates of incident CKD at follow-up (defined as new eGFR <60 mL/min/1.73 m2) among patients consuming higher levels of seafood-derived omega-3 fatty acids (EPA and DHA). The results showed no effect from plant-derived omega-3 fatty acids (ALA, commonly found in flax seeds). The study did not examine supplementation versus dietary sources of omega-3s, but the omega-3s were assumed to mainly account for dietary sources, given that many of the studies had begun prior to the introduction of omega-3 supplements to the market in the mid-2000s.
  • This analysis showed an association between increased omega-3 fatty acid consumption and reduced incidence of CKD. The effect was only found for seafood-derived omega-3s (EPA/DHA) and not for those derived from vegan sources (ALA). The study did not examine dietary versus supplement sources of omega-3s.
–  Timothy Overton, MD, MPH

Abstract

OBJECTIVE

To assess the prospective associations of circulating levels of omega 3 polyunsaturated fatty acid (n-3 PUFA) biomarkers (including plant derived α linolenic acid and seafood derived eicosapentaenoic acid, docosapentaenoic acid, and docosahexaenoic acid) with incident chronic kidney disease (CKD).

DESIGN

Pooled analysis.

DATA SOURCES

A consortium of 19 studies from 12 countries identified up to May 2020.

STUDY SELECTION

Prospective studies with measured n-3 PUFA biomarker data and incident CKD based on estimated glomerular filtration rate.

DATA EXTRACTION AND SYNTHESIS

Each participating cohort conducted de novo analysis with prespecified and consistent exposures, outcomes, covariates, and models. The results were pooled across cohorts using inverse variance weighted meta-analysis.

MAIN OUTCOME MEASURES

Primary outcome of incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m2. In a sensitivity analysis, incident CKD was defined as new onset estimated glomerular filtration rate <60 mL/min/1.73 m2 and <75% of baseline rate.

RESULTS

25 570 participants were included in the primary outcome analysis and 4944 (19.3%) developed incident CKD during follow-up (weighted median 11.3 years). In multivariable adjusted models, higher levels of total seafood n-3 PUFAs were associated with a lower incident CKD risk (relative risk per interquintile range 0.92, 95% confidence interval 0.86 to 0.98; P=0.009, I2=9.9%). In categorical analyses, participants with total seafood n-3 PUFA level in the highest fifth had 13% lower risk of incident CKD compared with those in the lowest fifth (0.87, 0.80 to 0.96; P=0.005, I2=0.0%). Plant derived α linolenic acid levels were not associated with incident CKD (1.00, 0.94 to 1.06; P=0.94, I2=5.8%). Similar results were obtained in the sensitivity analysis. The association appeared consistent across subgroups by age (≥60 v <60 years), estimated glomerular filtration rate (60-89 v ≥90 mL/min/1.73 m2), hypertension, diabetes, and coronary heart disease at baseline.

CONCLUSIONS

Higher seafood derived n-3 PUFA levels were associated with lower risk of incident CKD, although this association was not found for plant derived n-3 PUFAs. These results support a favourable role for seafood derived n-3 PUFAs in preventing CKD.

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