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Meta-Analysis
. 2018 Apr;22(2):124-132.
doi: 10.1111/1744-9987.12611. Epub 2017 Dec 22.

Effects of Omega-3 Fatty Acids on Markers of Inflammation in Patients With Chronic Kidney Disease: A Controversial Issue

Chun Hu  1 , Ming Yang  1 , Xuejing Zhu  1 , Peng Gao  1 , Shikun Yang  1   2 , Yachun Han  1 , Xianghui Chen  1 , Li Xiao  1 , Shuguang Yuan  1 , Fuyou Liu  1 , Yashpal S Kanwar  3   4 , Lin Sun  1
Affiliations
Meta-Analysis

Effects of Omega-3 Fatty Acids on Markers of Inflammation in Patients With Chronic Kidney Disease: A Controversial Issue

Chun Hu et al. Ther Apher Dial. 2018 Apr.

Abstract

Chronic kidney disease (CKD) is a global problem which contributes to a significant morbidity and mortality in China. Concomitant inflammatory state further boosts the mortality due to cardiovascular events in patients with CKD undergoing dialysis. There is a general notion that Omega-3 fatty acids including docosahexaenoic acids (DHA) and eicosapentaenoic (EPA) have certain health benefits perhaps via the regulation of inflammation. However, the anti-inflammatory effect of omega-3 fatty acids in patients with CKD is controversial. We analyzed the data of oral supplementation of omega-3 fatty acids in CKD patients by searching literature on database from inception to August 2016. The analysis included randomized controlled trials (RCTs) derived from multiple databases, and the effect of omega-3 fatty acids supplementation versus the control cohorts were compared. All of the data analysis was calculated by RevMan 5.2. A total of 12 RCTs involving 487 patients were included in the meta-analysis. Among them 254 patients received omega-3 fatty acids and 233 patients served as controls who received placebo. The meta-analysis revealed no statistical significance in serum levels of C-reactive protein (CRP) (SMD, -0.20; 95% CI, -0.44 to 0.05; P = 0.11), IL-6 (SMD, 0.00; 95% CI, -0.33 to 0.33; P = 0.99) and TNF-α (SMD, 0.14; 95% CI, -0.17 to 0.44; P = 0.38) between the omega-3 fatty acids supplementation group and control. This suggested that there is insufficient evidence to conclude the benefit of omega-3 fatty acids oral supplementation in reducing serum levels of CRP, IL-6 and TNF-α in patients with CKD.

Keywords: C-reactive protein; Chronic kidney disease; Dialysis; Interleukin-6; Omega-3 fatty acids; Tumor necrosis factor-α.

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Conflict of interest statement

Declaration of personal interests: None of the authors have any conflict of interest to declare.

Figures

Figure 1
Figure 1
Flow diagram of the literature selection and the exclusion process.
Figure 2
Figure 2
Study quality assessment.
Figure 3
Figure 3
Forest plot of studies comparing the role of omega-3 fatty acids supplementation versus placebo on serum inflammation markers in CKD patients.
Figure 4
Figure 4
Forest plot of studies comparing the role of omega-3 fatty acids supplementation versus placebo on serum inflammation markers in dialysis patients.
Figure 5
Figure 5
Funnel plots with MD or SMD for studies comparing supplementation of omega-3 fatty acids with placebo for the effect of inflammation in CKD patients. MD: mean differences, SMD: standardized mean difference
See this image and copyright information in PMC

References

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