CKD: Omega 3 Supplements (2018)

CKD: Omega 3 Supplements (2018)

• Intervention
  What is the effect of omega 3 fatty acid supplementation on all-cause mortality in adults with CKD on hemodialysis and post-transplant?

  • Conclusion

    Omega-3 supplementation did not affect mortality risk in patients on hemodialysis or post-transplant, but evidence is limited.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on all-cause mortality in adults with CKD on hemodialysis and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Berthoux F, Guerin C, Burgard G, Berthoux P, Alamartine E. One-year randomized controlled trial with omega-3 fatty acid-fish oil in clinical renal transplantation. Transplantation Proceedings 1992; 24:2578-82
      • Maachi K, Berthoux P, Burgard G, Alamartine E, Berthoux F. Results of a 1-year randomized controlled trial with omega-3 fatty acid fish oil in renal transplantation under triple immunosuppressive therapy. Transplantation Proceedings 1995; 27:846-9
      • Svensson M, Schmidt E, Jørgensen K, Christensen J. N-3 fatty acids as secondary prevention against cardiovascular events in patients who undergo chronic hemodialysis: a randomized, placebo-controlled intervention trial. Clinical Journal of the American Society of Nephrology 2006; 1:780-6
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on cardiovascular disease events in adults with CKD on hemodialysis?

  • Conclusion

    Evidence suggests that omega-3 supplementation may have no effect on cardiovascular disease events in patients on hemodialysis, though effect may vary according to type of event. Evidence was limited.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on cardiovascular disease events in adults with CKD on hemodialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Lok C, Moist L, Hemmelgarn B, Tonelli M, Vazquez M, Dorval M, Oliver M, Donnelly S, Allon M, Stanley K. Effect of fish oil supplementation on graft patency and cardiovascular events among patients with new synthetic arteriovenous hemodialysis grafts: a randomized controlled trial. JAMA 2012; 307:1809-16
      • Svensson M, Schmidt E, Jørgensen K, Christensen J. N-3 fatty acids as secondary prevention against cardiovascular events in patients who undergo chronic hemodialysis: a randomized, placebo-controlled intervention trial. Clinical Journal of the American Society of Nephrology 2006; 1:780-6
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on hypertension medication in adults with CKD on hemodialysis?

  • Conclusion

    Omega-3 supplementation may decrease dependency on anti-hypertensive medication in hemodialysis patients, but evidence was limited.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on hypertension medication in adults with CKD on hemodialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Lok C, Moist L, Hemmelgarn B, Tonelli M, Vazquez M, Dorval M, Oliver M, Donnelly S, Allon M, Stanley K. Effect of fish oil supplementation on graft patency and cardiovascular events among patients with new synthetic arteriovenous hemodialysis grafts: a randomized controlled trial. JAMA 2012; 307:1809-16
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on depression in adults with CKD on hemodialysis?

  • Conclusion

    Omega 3 supplementation (~1800 mg/d for four months) may improve depression scores in patients on hemodialysis, but evidence was limited.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on depression in adults with CKD on hemodialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Gharekhani A, Khatami M, Dashti-Khavidaki S, Razeghi E, Noorbala A, Hashemi-Nazari S, Mansournia M. The effect of omega-3 fatty acids on depressive symptoms and inflammatory markers in maintenance hemodialysis patients: a randomized, placebo-controlled clinical trial. European Journal of Clinical Pharmacology 2014; 70:655-65
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on hemodialysis access in adults with CKD 5D on hemodialysis?

  • Conclusion

    Omega-3 supplementation of approximately 1.5-6 g of DHA and EPA combined for 8-12 months had no effect on hemodialysis access, including for AVG and AVF.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on hemodialysis access in adults with CKD 5D on hemodialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bowden R, Wilson R, Gentile M, Ounpraseuth S, Moore P, Leutholtz B. Effects of omega-3 fatty acid supplementation on vascular access thrombosis in polytetrafluorethylene grafts. Journal of Renal Nutrition: the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2007; 17:126-31
      • Irish A, Viecelli A, Hawley C, Hooi L, Pascoe E, Paul-Brent P, Badve S, Mori T, Cass A, Kerr P, Voss D, Ong L, Polkinghorne K. Effect of Fish Oil Supplementation and Aspirin Use on Arteriovenous Fistula Failure in Patients Requiring Hemodialysis: A Randomized Clinical Trial. JAMA Internal Medicine 2017; 177:184-193
      • Lok C, Moist L, Hemmelgarn B, Tonelli M, Vazquez M, Dorval M, Oliver M, Donnelly S, Allon M, Stanley K. Effect of fish oil supplementation on graft patency and cardiovascular events among patients with new synthetic arteriovenous hemodialysis grafts: a randomized controlled trial. JAMA 2012; 307:1809-16
      • Schmitz P, McCloud L, Reikes S, Leonard C, Gellens M. Prophylaxis of hemodialysis graft thrombosis with fish oil: double-blind, randomized, prospective trial. Journal of the American Society of Nephrology 2002; 13:184-90
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on rejection episodes and graft survival in adults with CKD who are non-dialyzed and post-transplant?

  • Conclusion

    Omega-3 supplementation did not affect rejection episodes or graft survival in renal transplant patients, but evidence was limited and dated and may not be applicable to current clients.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on rejection episodes and graft survival in adults with CKD who are non-dialyzed and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bennett W, Carpenter C, Shapiro M, Strom T, Hefty D, Tillman M, Abrams J, Ryan D, Kelley V. Delayed omega-3 fatty acid supplements in renal transplantation. A double-blind, placebo-controlled study. Transplantation 1995; 59:352-6
      • Berthoux F, Guerin C, Burgard G, Berthoux P, Alamartine E. One-year randomized controlled trial with omega-3 fatty acid-fish oil in clinical renal transplantation. Transplantation Proceedings 1992; 24:2578-82
      • Maachi K, Berthoux P, Burgard G, Alamartine E, Berthoux F. Results of a 1-year randomized controlled trial with omega-3 fatty acid fish oil in renal transplantation under triple immunosuppressive therapy. Transplantation Proceedings 1995; 27:846-9
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on total, LDL and HDL cholesterol and triglyceride levels in adults with CKD 1-5D and post-transplant?

  • Conclusion

    LC Omega-3 PUFA supplementation did not affect total cholesterol levels in hemodialysis (HD) or non-dialyzed patients. The preponderance of evidence suggests that omega-3 supplementation from fish oil may lower low-density lipoprotein (LDL) cholesterol levels by approximately 5 mg/dL and increase high-density lipoprotein (HDL) levels by approximtely 7 mg/dL in HD patients compared to controls when administered at 1.3-3g/d, though evidence was somewhat mixed. Ground flaxseed may have a much larger effect on lowering LDL cholesterol and triglyceride levels in HD patients, but results were limited. In HD patients, omega 3 supplementation (1.3-4g/d) decreases triglyceride levels, and this effect was also seen in non-dialyzed patients. Omega-3 fish oil supplementation did not affect LDL cholesterol levels and affect on HDL levels was unclear in non-dialyzed patients and evidence was limited and inconclusive with renal transplant patients. Heterogeneity of results was high and most studies did not appropriately control for confounding variables, so results should be interpreted with caution.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on total and LDL cholesterol and triglyceride levels in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • An W, Lee S, Son Y, Kim S, Kim K, Han J, Bae H, Rha S, Park Y. Omega-3 fatty acid supplementation increases 1,25-dihydroxyvitamin D and fetuin-A levels in dialysis patients. Nutrition Research 2012; 32:495-502
      • Bennett W, Carpenter C, Shapiro M, Strom T, Hefty D, Tillman M, Abrams J, Ryan D, Kelley V. Delayed omega-3 fatty acid supplements in renal transplantation. A double-blind, placebo-controlled study. Transplantation 1995; 59:352-6
      • Bouzidi N, Mekki K, Boukaddoum A, Dida N, Kaddous A, Bouchenak M. Effects of omega-3 polyunsaturated fatty-acid supplementation on redox status in chronic renal failure patients with dyslipidemia. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2010; 20:321-8
      • Bowden R, Jitomir J, Wilson R, Gentile M. Effects of omega-3 fatty acid supplementation on lipid levels in endstage renal disease patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2009; 19:259-66
      • Daud Z, Tubie B, Adams J, Quainton T, Osia R, Tubie S, Kaur D, Khosla P, Sheyman M. Effects of protein and omega-3 supplementation, provided during regular dialysis sessions, on nutritional and inflammatory indices in hemodialysis patients. Vascular Health and Risk Management 2012; 8:187-95
      • Ewers B, Riserus U, Marckmann P. Effects of unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation in hemodialysis patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2009; 19:401-11
      • Guebre-Egziabher F, Debard C, Drai J ,Denis L, Pesenti S, Bienvenu J, Vidal H, Laville M, Fouque D. Differential dose effect of fish oil on inflammation and adipose tissue gene expression in chronic kidney disease patients. Nutrition (Burbank, Los Angeles County, Calif.) 2013; 29:730-6
      • Khajehdehi P. Lipid-lowering effect of polyunsaturated fatty acids in hemodialysis patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2000; 10:191-5
      • Khalatbari Soltani S, Jamaluddin R, Tabibi H, Mohd Yusof B, Atabak S, Loh S, Rahmani L. Effects of flaxseed consumption on systemic inflammation and serum lipid profile in hemodialysis patients with lipid abnormalities. Hemodialysis International. International Symposium on Home Hemodialysis 2013; 17:275-81
      • Kooshki A, Taleban F, Tabibi H, Hedayati M. Effects of omega-3 fatty acids on serum lipids, lipoprotein (a), and hematologic factors in hemodialysis patients. Renal Failure 2011; 33:892-8
      • Lemos J, Alencastro M, Konrath A, Cargnin M, Manfro R. Flaxseed oil supplementation decreases C-reactive protein levels in chronic hemodialysis patients. Nutrition Research 2012; 32:921-7
      • Mori T, Burke V, Puddey I, Irish A, Cowpland C, Beilin L, Dogra G, Watts G. The effects of [omega]3 fatty acids and coenzyme Q10 on blood pressure and heart rate in chronic kidney disease: a randomized controlled trial. Journal of Hypertension 2009; 27:1863-72
      • Ramezani M, Nazemian F, Shamsara J, Koohrokhi R, Mohammadpour A. Effect of omega-3 fatty acids on plasma level of 8-isoprostane in kidney transplant patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2011; 21:196-9
      • Saifullah A, Watkins B, Saha C, Li Y, Moe S, Friedman A. Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients--a pilot study. Nephrology, Dialysis, Transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2007; 22:3561-7
      • Schmitz P, McCloud L, Reikes S, Leonard C, Gellens M. Prophylaxis of hemodialysis graft thrombosis with fish oil: double-blind, randomized, prospective trial. Journal of the American Society of Nephrology 2002; 13:184-90
      • Sorensen G, Svensson M, Strandhave C, Schmidt E, Jorgensen K, Christensen J. 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. Journal of Renal Nutrition 2015; 25:376-380
      • Svensson M, Christensen J, Sølling J, Schmidt E. The effect of n-3 fatty acids on plasma lipids and lipoproteins and blood pressure in patients with CRF. American Journal of Kidney Diseases : the official journal of the National Kidney Foundation 2004; 44:77-83
      • Tayebi-Khosroshahi H, Dehgan R, Habibi Asl B, Safaian A, Panahi F, Estakhri R, Purasgar B. Effect of omega-3 supplementation on serum level of homocysteine in hemodialysis patients. Iranian Journal of Kidney Diseases 2013; 7:479-84
      • Taziki O, Lessan-Pezeshki M, Akha O, Vasheghani F. The effect of low dose omega-3 on plasma lipids in hemodialysis patients. Saudi Journal of Kidney Diseases and Transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 2007; 18:571-6
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on blood pressure in adults with hemodialysis or renal transplant?

  • Conclusion

    In hemodialysis patients, the there was no effect of omega-3 supplementation on diastolic blood pressure (DBP), but a dose of 2.4g/day for 8 weeks may decrease systolic blood pressure (SBP). In renal transplant patients, omega-3 supplementation had decreased blood pressure when given in a range of 4-18g/day for 3-6 months.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on blood pressure in adults with hemodialysis or renal transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bennett W, Carpenter C, Shapiro M, Strom T, Hefty D, Tillman M, Abrams J, Ryan D, Kelley V. Delayed omega-3 fatty acid supplements in renal transplantation. A double-blind, placebo-controlled study. Transplantation 1995; 59:352-6
      • Khajehdehi P. Lipid-lowering effect of polyunsaturated fatty acids in hemodialysis patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2000; 10:191-5
      • Lok C, Moist L, Hemmelgarn B, Tonelli M, Vazquez M, Dorval M, Oliver M, Donnelly S, Allon M, Stanley K. Effect of fish oil supplementation on graft patency and cardiovascular events among patients with new synthetic arteriovenous hemodialysis grafts: a randomized controlled trial. JAMA 2012; 307:1809-16
      • Schmitz P, McCloud L, Reikes S, Leonard C, Gellens M. Prophylaxis of hemodialysis graft thrombosis with fish oil: double-blind, randomized, prospective trial. Journal of the American Society of Nephrology 2002; 13:184-90
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on blood pressure in non-dialyzed adults with CKD?

  • Conclusion

    There was no effect of omega-3 supplementation on blood pressure in non-dialyzed patients.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on blood pressure in non-dialyzed adults with CKD?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Mori T, Burke V, Puddey I, Irish A, Cowpland C, Beilin L, Dogra G, Watts G. The effects of [omega]3 fatty acids and coenzyme Q10 on blood pressure and heart rate in chronic kidney disease: a randomized controlled trial. Journal of Hypertension 2009; 27:1863-72
      • Svensson M, Christensen J, Sølling J, Schmidt E. The effect of n-3 fatty acids on plasma lipids and lipoproteins and blood pressure in patients with CRF. American Journal of Kidney Diseases : the official journal of the National Kidney Foundation 2004; 44:77-83
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on homocysteine levels in adults with CKD 5D on hemodialysis?

  • Conclusion

    Omega-3s supplementation did not affect homocysteine levels in hemodialysis patients. However, heterogeneity of pooled data was high, so results should be interpreted with caution.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on homocysteine levels in adults with CKD 5D on hemodialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Beavers K, Beavers D, Bowden R, Wilson R, Gentile M. Omega-3 fatty acid supplementation and total homocysteine levels in end-stage renal disease patients. Nephrology 2008; 13:284-8
      • Bowden R, Wilson R, Deike E, Gentile M. Fish oil supplementation lowers C-reactive protein levels independent of triglyceride reduction in patients with end-stage renal disease. Nutrition in Clinical Practice : official publication of the American Society for Parenteral and Enteral Nutrition 2009; 24:508-12
      • Rasmussen L, Svensson M, Jørgensen K, Schmidt E, Christensen J. The content of docosahexaenoic acid in serum phospholipid is inversely correlated with plasma homocysteine levels in patients with end-stage renal disease. Nutrition Research 2010; 30:535-40
      • Tayebi-Khosroshahi H, Dehgan R, Habibi Asl B, Safaian A, Panahi F, Estakhri R, Purasgar B. Effect of omega-3 supplementation on serum level of homocysteine in hemodialysis patients. Iranian Journal of Kidney Diseases 2013; 7:479-84
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on eGFR in adults with CKD 1-5D and post-transplant?

  • Conclusion

    Omega-3 supplementation (2.1g/d to 3.6 g/d) in non-dialyzed or post-transplant patients did not have any significant effect on preserving eGFR compared to control groups or olive oil/corn oil supplementation.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on eGFR in adults with CKD 1-5D and post-transplant?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bennett W, Carpenter C, Shapiro M, Strom T, Hefty D, Tillman M, Abrams J, Ryan D, Kelley V. Delayed omega-3 fatty acid supplements in renal transplantation. A double-blind, placebo-controlled study. Transplantation 1995; 59:352-6
      • Berthoux F, Guerin C, Burgard G, Berthoux P, Alamartine E. One-year randomized controlled trial with omega-3 fatty acid-fish oil in clinical renal transplantation. Transplantation Proceedings 1992; 24:2578-82
      • Bouzidi N, Mekki K, Boukaddoum A, Dida N, Kaddous A, Bouchenak M. Effects of omega-3 polyunsaturated fatty-acid supplementation on redox status in chronic renal failure patients with dyslipidemia. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2010; 20:321-8
      • Guebre-Egziabher F, Debard C, Drai J ,Denis L, Pesenti S, Bienvenu J, Vidal H, Laville M, Fouque D. Differential dose effect of fish oil on inflammation and adipose tissue gene expression in chronic kidney disease patients. Nutrition (Burbank, Los Angeles County, Calif.) 2013; 29:730-6
      • Maachi K, Berthoux P, Burgard G, Alamartine E, Berthoux F. Results of a 1-year randomized controlled trial with omega-3 fatty acid fish oil in renal transplantation under triple immunosuppressive therapy. Transplantation Proceedings 1995; 27:846-9
      • Mori T, Burke V, Puddey I, Irish A, Cowpland C, Beilin L, Dogra G, Watts G. The effects of [omega]3 fatty acids and coenzyme Q10 on blood pressure and heart rate in chronic kidney disease: a randomized controlled trial. Journal of Hypertension 2009; 27:1863-72
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on creatinine levels in adults with CKD, non-dialyzed?

  • Conclusion

    Omega-3 supplementation has no effect on creatinine levels in non-dialyzed CKD patients.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on creatinine levels in adults with CKD, non-dialyzed?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Bouzidi N, Mekki K, Boukaddoum A, Dida N, Kaddous A, Bouchenak M. Effects of omega-3 polyunsaturated fatty-acid supplementation on redox status in chronic renal failure patients with dyslipidemia. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2010; 20:321-8
      • Guebre-Egziabher F, Debard C, Drai J ,Denis L, Pesenti S, Bienvenu J, Vidal H, Laville M, Fouque D. Differential dose effect of fish oil on inflammation and adipose tissue gene expression in chronic kidney disease patients. Nutrition (Burbank, Los Angeles County, Calif.) 2013; 29:730-6
      • Svensson M, Christensen J, Sølling J, Schmidt E. The effect of n-3 fatty acids on plasma lipids and lipoproteins and blood pressure in patients with CRF. American Journal of Kidney Diseases : the official journal of the National Kidney Foundation 2004; 44:77-83
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on calcium and phosphorus levels in adults with CKD 5D on hemodialysis?

  • Conclusion

    Omega-3 supplementation had an unclear effect on calcium and phosphorus levels compared to control or a placebo group in hemodialysis subjects . 
     

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on calcium and phosphorus levels in adults with CKD 5D on hemodialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • An W, Lee S, Son Y, Kim S, Kim K, Han J, Bae H, Rha S, Park Y. Omega-3 fatty acid supplementation increases 1,25-dihydroxyvitamin D and fetuin-A levels in dialysis patients. Nutrition Research 2012; 32:495-502
      • Lemos J, Alencastro M, Konrath A, Cargnin M, Manfro R. Flaxseed oil supplementation decreases C-reactive protein levels in chronic hemodialysis patients. Nutrition Research 2012; 32:921-7
      • Tayebi-Khosroshahi H, Dehgan R, Habibi Asl B, Safaian A, Panahi F, Estakhri R, Purasgar B. Effect of omega-3 supplementation on serum level of homocysteine in hemodialysis patients. Iranian Journal of Kidney Diseases 2013; 7:479-84
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on sodium and potassium levels in adults with CKD 5D on hemodialysis?

  • Conclusion

    Omega-3 supplementation had an unclear effect on sodium and potassium levels compared to placebo group in patients on hemodialysis.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on sodium and potassium levels in adults with CKD 5D on hemodialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Tayebi-Khosroshahi H, Dehgan R, Habibi Asl B, Safaian A, Panahi F, Estakhri R, Purasgar B. Effect of omega-3 supplementation on serum level of homocysteine in hemodialysis patients. Iranian Journal of Kidney Diseases 2013; 7:479-84
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on hemoglobin levels in adults with CKD 5D on dialysis?

  • Conclusion

    Omega 3 supplementation from 2-3g/day increased hemoglobin levels in hemodialysis patients [Mean (95% CI): 0.227 (0.030, 0.423) g/dL], but most studies did not describe participant anemia protocols.

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on hemoglobin levels in adults with CKD 5D on dialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • An W, Lee S, Son Y, Kim S, Kim K, Han J, Bae H, Rha S, Park Y. Omega-3 fatty acid supplementation increases 1,25-dihydroxyvitamin D and fetuin-A levels in dialysis patients. Nutrition Research 2012; 32:495-502
      • Daud Z, Tubie B, Adams J, Quainton T, Osia R, Tubie S, Kaur D, Khosla P, Sheyman M. Effects of protein and omega-3 supplementation, provided during regular dialysis sessions, on nutritional and inflammatory indices in hemodialysis patients. Vascular Health and Risk Management 2012; 8:187-95
      • Kooshki A, Taleban F, Tabibi H, Hedayati M. Effects of omega-3 fatty acids on serum lipids, lipoprotein (a), and hematologic factors in hemodialysis patients. Renal Failure 2011; 33:892-8
      • Lemos J, Alencastro M, Konrath A, Cargnin M, Manfro R. Flaxseed oil supplementation decreases C-reactive protein levels in chronic hemodialysis patients. Nutrition Research 2012; 32:921-7
      • Tayebi-Khosroshahi H, Dehgan R, Habibi Asl B, Safaian A, Panahi F, Estakhri R, Purasgar B. Effect of omega-3 supplementation on serum level of homocysteine in hemodialysis patients. Iranian Journal of Kidney Diseases 2013; 7:479-84
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on CRP levels in adults with CKD 5D on hemodialysis?

  • Conclusion

    Omega-3 supplementation had unclear effect on c-reactive protein (CRP) levels compared to placebo groups or control groups among patients on hemodialysis.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on CRP levels in adults with CKD 5D on hemodialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • An W, Lee S, Son Y, Kim S, Kim K, Han J, Bae H, Rha S, Park Y. Omega-3 fatty acid supplementation increases 1,25-dihydroxyvitamin D and fetuin-A levels in dialysis patients. Nutrition Research 2012; 32:495-502
      • Bowden R, Wilson R, Deike E, Gentile M. Fish oil supplementation lowers C-reactive protein levels independent of triglyceride reduction in patients with end-stage renal disease. Nutrition in Clinical Practice : official publication of the American Society for Parenteral and Enteral Nutrition 2009; 24:508-12
      • Daud Z, Tubie B, Adams J, Quainton T, Osia R, Tubie S, Kaur D, Khosla P, Sheyman M. Effects of protein and omega-3 supplementation, provided during regular dialysis sessions, on nutritional and inflammatory indices in hemodialysis patients. Vascular Health and Risk Management 2012; 8:187-95
      • Ewers B, Riserus U, Marckmann P. Effects of unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation in hemodialysis patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2009; 19:401-11
      • Gharekhani A, Khatami M, Dashti-Khavidaki S, Razeghi E, Abdollahi A, Hashemi-Nazari S, Mansournia M. Effects of oral supplementation with omega-3 fatty acids on nutritional state and inflammatory markers in maintenance hemodialysis patients. Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2014; 24:177-85
      • Harving F, Svensson M, Flyvbjerg A, Schmidt E, Jørgensen K, Eriksen H, Christensen J. n-3 polyunsaturated fatty acids and adiponectin in patients with end-stage renal disease. Clinical Nephrology 2015; 83:279-85
      • Hung A, Booker C, Ellis C, Siew E, Graves A, Shintani A, Abumrad N, Himmelfarb J, Ikizler T. Omega-3 fatty acids inhibit the up-regulation of endothelial chemokines in maintenance hemodialysis patients. Nephrology, Dialysis, Transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2015; 30:266-74
      • Khalatbari Soltani S, Jamaluddin R, Tabibi H, Mohd Yusof B, Atabak S, Loh S, Rahmani L. Effects of flaxseed consumption on systemic inflammation and serum lipid profile in hemodialysis patients with lipid abnormalities. Hemodialysis International. International Symposium on Home Hemodialysis 2013; 17:275-81
      • Kooshki A, Taleban F, Tabibi H, Hedayati M. Effects of marine omega-3 fatty acids on serum systemic and vascular inflammation markers and oxidative stress in hemodialysis patients. Annals of Nutrition & Metabolism 2011; 58:197-202
      • Lemos J, Alencastro M, Konrath A, Cargnin M, Manfro R. Flaxseed oil supplementation decreases C-reactive protein levels in chronic hemodialysis patients. Nutrition Research 2012; 32:921-7
      • Poulia K, Panagiotakos D, Tourlede E, Rezou A, Stamatiadis D, Boletis J, Zampelas A. Omega-3 fatty acids supplementation does not affect serum lipids in chronic hemodialysis patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2011; 21:479-84
      • Saifullah A, Watkins B, Saha C, Li Y, Moe S, Friedman A. Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients--a pilot study. Nephrology, Dialysis, Transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2007; 22:3561-7
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on IL-6 levels in adults with CKD on hemodialysis?

  • Conclusion

    Omega-3 supplementation had unclear effect on interleukin-6 (IL-6) levels compared to placebo groups among patients on hemodialysis .

  • Grade: II
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on IL-6 levels in adults with CKD on hemodialysis?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Gharekhani A, Khatami M, Dashti-Khavidaki S, Razeghi E, Abdollahi A, Hashemi-Nazari S, Mansournia M. Effects of oral supplementation with omega-3 fatty acids on nutritional state and inflammatory markers in maintenance hemodialysis patients. Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2014; 24:177-85
      • Himmelfarb J, Phinney S, Ikizler T, Kane J, McMonagle E, Miller G. Gamma-tocopherol and docosahexaenoic acid decrease inflammation in dialysis patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2007; 17:296-304
      • Hung A, Booker C, Ellis C, Siew E, Graves A, Shintani A, Abumrad N, Himmelfarb J, Ikizler T. Omega-3 fatty acids inhibit the up-regulation of endothelial chemokines in maintenance hemodialysis patients. Nephrology, Dialysis, Transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2015; 30:266-74
      • Kooshki A, Taleban F, Tabibi H, Hedayati M. Effects of marine omega-3 fatty acids on serum systemic and vascular inflammation markers and oxidative stress in hemodialysis patients. Annals of Nutrition & Metabolism 2011; 58:197-202
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on inflammatory marker levels in non-dialyzed adults with CKD?

  • Conclusion

    Omega-3 supplementation had unclear effect on c-reactive protein (CRP)  and Iinterleukin-6 (L-6) levels in non-dialyzed patients compared to placebo groups or control groups.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on inflammatory marker levels in non-dialyzed adults with CKD?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • Deike E, Bowden R, Moreillon J ,Griggs J, Wilson R, Cooke M, Shelmadine B,B eaujean A. The effects of fish oil supplementation on markers of inflammation in chronic kidney disease patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2012; 22:572-7
      • Guebre-Egziabher F, Debard C, Drai J ,Denis L, Pesenti S, Bienvenu J, Vidal H, Laville M, Fouque D. Differential dose effect of fish oil on inflammation and adipose tissue gene expression in chronic kidney disease patients. Nutrition (Burbank, Los Angeles County, Calif.) 2013; 29:730-6
      • Madsen T, Schmidt E, Christensen J. The effect of n-3 fatty acids on C-reactive protein levels in patients with chronic renal failure. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2007; 17:258-63
      • Mori T, Burke V, Puddey I, Irish A, Cowpland C, Beilin L, Dogra G, Watts G. The effects of [omega]3 fatty acids and coenzyme Q10 on blood pressure and heart rate in chronic kidney disease: a randomized controlled trial. Journal of Hypertension 2009; 27:1863-72
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on anthropometric measurements in adults with CKD 1-5D?

  • Conclusion

    Omega-3 supplementation has an unclear effect on BMI and body weight compared to control or placebo groups in patients who were non-dialyzed or on hemodialysis. 

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on anthropometric measurements in adults with CKD 1-5D?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • An W, Lee S, Son Y, Kim S, Kim K, Han J, Bae H, Rha S, Park Y. Omega-3 fatty acid supplementation increases 1,25-dihydroxyvitamin D and fetuin-A levels in dialysis patients. Nutrition Research 2012; 32:495-502
      • Daud Z, Tubie B, Adams J, Quainton T, Osia R, Tubie S, Kaur D, Khosla P, Sheyman M. Effects of protein and omega-3 supplementation, provided during regular dialysis sessions, on nutritional and inflammatory indices in hemodialysis patients. Vascular Health and Risk Management 2012; 8:187-95
      • Ewers B, Riserus U, Marckmann P. Effects of unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation in hemodialysis patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2009; 19:401-11
      • Gharekhani A, Khatami M, Dashti-Khavidaki S, Razeghi E, Abdollahi A, Hashemi-Nazari S, Mansournia M. Effects of oral supplementation with omega-3 fatty acids on nutritional state and inflammatory markers in maintenance hemodialysis patients. Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2014; 24:177-85
      • Guebre-Egziabher F, Debard C, Drai J ,Denis L, Pesenti S, Bienvenu J, Vidal H, Laville M, Fouque D. Differential dose effect of fish oil on inflammation and adipose tissue gene expression in chronic kidney disease patients. Nutrition (Burbank, Los Angeles County, Calif.) 2013; 29:730-6
      • Harving F, Svensson M, Flyvbjerg A, Schmidt E, Jørgensen K, Eriksen H, Christensen J. n-3 polyunsaturated fatty acids and adiponectin in patients with end-stage renal disease. Clinical Nephrology 2015; 83:279-85
      • Kooshki A, Taleban F, Tabibi H, Hedayati M. Effects of marine omega-3 fatty acids on serum systemic and vascular inflammation markers and oxidative stress in hemodialysis patients. Annals of Nutrition & Metabolism 2011; 58:197-202
      • Mori T, Burke V, Puddey I, Irish A, Cowpland C, Beilin L, Dogra G, Watts G. The effects of [omega]3 fatty acids and coenzyme Q10 on blood pressure and heart rate in chronic kidney disease: a randomized controlled trial. Journal of Hypertension 2009; 27:1863-72
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)
     
  What is the effect of omega 3 fatty acid supplementation on albumin levels in adults with CKD 1-5D?

  • Conclusion

    Omega-3 supplementation did not have any effect on albumin levels compared to control groups or placebo groups in patients who were non-dialyzed or on hemodialysis.

  • Grade: III
    • Grade I means there is Good/Strong evidence supporting the statement;
    • Grade II is Fair;
    • Grade III is Limited/Weak;
    • Grade IV is Expert Opinion Only;
    • Grade V is Not Assignable.
    • High (A) means we are very confident that the true effect lies close to that of the estimate of the effect;
    • Moderate (B) means we are moderately confident in the effect estimate;
    • Low (C) means our confidence in the effect estimate is limited;
    • Very Low (D) means we have very little confidence in the effect estimate.
    • Ungraded means a grade is not assignable.
  • Evidence Summary: What is the effect of omega 3 fatty acid supplementation on albumin levels in adults with CKD 1-5D?
    • Detail
    • Quality Rating Summary
      For a summary of the Quality Rating results, click here.
    • Worksheets
      • An W, Lee S, Son Y, Kim S, Kim K, Han J, Bae H, Rha S, Park Y. Omega-3 fatty acid supplementation increases 1,25-dihydroxyvitamin D and fetuin-A levels in dialysis patients. Nutrition Research 2012; 32:495-502
      • Bouzidi N, Mekki K, Boukaddoum A, Dida N, Kaddous A, Bouchenak M. Effects of omega-3 polyunsaturated fatty-acid supplementation on redox status in chronic renal failure patients with dyslipidemia. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2010; 20:321-8
      • Daud Z, Tubie B, Adams J, Quainton T, Osia R, Tubie S, Kaur D, Khosla P, Sheyman M. Effects of protein and omega-3 supplementation, provided during regular dialysis sessions, on nutritional and inflammatory indices in hemodialysis patients. Vascular Health and Risk Management 2012; 8:187-95
      • Ewers B, Riserus U, Marckmann P. Effects of unsaturated fat dietary supplements on blood lipids, and on markers of malnutrition and inflammation in hemodialysis patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2009; 19:401-11
      • Gharekhani A, Khatami M, Dashti-Khavidaki S, Razeghi E, Abdollahi A, Hashemi-Nazari S, Mansournia M. Effects of oral supplementation with omega-3 fatty acids on nutritional state and inflammatory markers in maintenance hemodialysis patients. Journal of renal nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2014; 24:177-85
      • Guebre-Egziabher F, Debard C, Drai J ,Denis L, Pesenti S, Bienvenu J, Vidal H, Laville M, Fouque D. Differential dose effect of fish oil on inflammation and adipose tissue gene expression in chronic kidney disease patients. Nutrition (Burbank, Los Angeles County, Calif.) 2013; 29:730-6
      • Hung A, Booker C, Ellis C, Siew E, Graves A, Shintani A, Abumrad N, Himmelfarb J, Ikizler T. Omega-3 fatty acids inhibit the up-regulation of endothelial chemokines in maintenance hemodialysis patients. Nephrology, Dialysis, Transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2015; 30:266-74
      • Poulia K, Panagiotakos D, Tourlede E, Rezou A, Stamatiadis D, Boletis J, Zampelas A. Omega-3 fatty acids supplementation does not affect serum lipids in chronic hemodialysis patients. Journal of Renal Nutrition : the official journal of the Council on Renal Nutrition of the National Kidney Foundation 2011; 21:479-84
      • Saifullah A, Watkins B, Saha C, Li Y, Moe S, Friedman A. Oral fish oil supplementation raises blood omega-3 levels and lowers C-reactive protein in haemodialysis patients--a pilot study. Nephrology, Dialysis, Transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association 2007; 22:3561-7
  • Search Plan and Results: CKD: Macronutrients : Nutritional Supplements (2018)