The effect of omega-3 fatty acid supplementation on oxidative stress in continuous ambulatory peritoneal dialysis patients


Department of Nephrology, Isfahan Kidney Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran


Background: End stage renal disease (ESRD) is a condition that inflammation and oxidative stress plays an important role in damaging to tissues, especially, in the vascular system. The effect of omega-3 fatty acids is well-documented in some inflammatory diseases via eicosapentanoic acid and docosahexanoic acid components of fish oil. The aim of this study was to investigate the effects of dietary omega-3 fatty acid supplementation on levels of lipid peroxidation and oxidative sttress in ESRD patients.
Materials and Methods: This randomized controlled double-blind clinical trial consisted of 90 patients on chronic ambulatory peritoneal dialysis (CAPD). One group was treated orally with 3000 mg omega-3, per day for 8 weeks (n = 45) and the other matched group by placebo (n = 45). Serum levels of lipids, iron, ferritin, Protrombin Time, Partial thromboplastin time, superoxide dismutase (SOD), and reduced glutathione (GH) were measured at the beginning and at 8 weeks.
Results: Our results showed that SOD and reduced GH were not significantly changed in omega-3 group where lipid profile showed no significant changes too. Erythropoietin requirements also had no significant differences.
Conclusion: Incorporation of omega-3 fatty acids to CAPD patients had no beneficial effects on oxidative stress but should evaluate more.


1. Himmelfarb J. Linking oxidative stress and inflammation in kidney disease: Which is the chicken and which is the egg? Semin Dial 2004;17:449-54.  Back to cited text no. 1
2. Morena M, Delbosc S, Dupuy AM, Canaud B, Cristol JP. Overproduction of reactive oxygen species in end-stage renal disease patients: A potential component of hemodialysis-associated inflammation. Hemodial Int 2005;9:37-46.  Back to cited text no. 2
3. Himmelfarb J, Stenvinkel P, Ikizler TA, Hakim RM. The elephant in uremia: Oxidant stress as a unifying concept of cardiovascular disease in uremia. Kidney Int 2002;62:1524-38.  Back to cited text no. 3
4. Weydert CJ, Cullen JJ. Measurement of superoxide dismutase, catalase and glutathione peroxidase in cultured cells and tissue. Nat Protoc 2010;5:51-66.  Back to cited text no. 4
5. Cristol JP, Bosc JY, Badiou S, Leblanc M, Lorrho R, Descomps B, et al. Erythropoietin and oxidative stress in haemodialysis: Beneficial effects of vitamin E supplementation. Nephrol Dial Transplant 1997;12:2312-7.  Back to cited text no. 5
6. Attia AM, Nasr HM. Evaluation of protective effrct of omega-3 fatty acids and selenium on paraquat intoxicated rats. Slovak J Anim Sci 2009;42:180-7.  Back to cited text no. 6
7. Pekovic PG, Milutinovic RZ, Gluvic Z, Lackovic M, Medic DR, Glibetic M. Inflammation, nutritional status PUFA profile and outcome in hemodialysis patients. Arch Biol Sci 2012;64:1173-80.  Back to cited text no. 7
8. Friedman A, Moe S. Review of the effects of omega-3 supplementation in dialysis patients. Clin J Am Soc Nephrol 2006;1:182-92.  Back to cited text no. 8
9. Leaf A, Kang JX, Xiao YF, Billman GE. Clinical prevention of sudden cardiac death by n-3 polyunsaturated fatty acids and mechanism of prevention of arrhythmias by n-3 fish oils. Circulation 2003;107:2646-52.  Back to cited text no. 9
10. McGiff JC, Quilley J. 20-hydroxyeicosatetraenoic acid and epoxyeicosatrienoic acids and blood pressure. Curr Opin Nephrol Hypertens 2001;10:231-7.  Back to cited text no. 10
11. Kalousová M, Sulková S, Fialová L, Soukupová J, Malbohan IM, Spacek P, et al. Glycoxidation and inflammation in chronic haemodialysis patients. Nephrol Dial Transplant 2003;18:2577-81.  Back to cited text no. 11
12. Tayyebi-Khosroshahi H, Houshyar J, Tabrizi A, Vatankhah AM, Razzagi Zonouz N, Dehghan-Hesari R. Effect of omega-3 fatty acid on oxidative stress in patients on hemodialysis. Iran J Kidney Dis 2010;4:322-6.  Back to cited text no. 12
13. Dietary supplementation with n-3 polyunsaturated fatty acids and vitamin E after myocardial infarction: Results of the GISSI-Prevenzione trial. Gruppo Italiano per lo Studio della Sopravvivenza nell'Infarto miocardico. Lancet 1999;354:447-55.  Back to cited text no. 13
14. Calder PC. Session 3: Joint Nutrition Society and Irish Nutrition and Dietetic Institute Symposium on 'Nutrition and autoimmune disease' PUFA, inflammatory processes and rheumatoid arthritis. Proc Nutr Soc 2008;67:409-18.  Back to cited text no. 14
15. Belluzzi A, Brignola C, Campieri M, Pera A, Boschi S, Miglioli M. Effect of an enteric-coated fish-oil preparation on relapses in Crohn's disease. N Engl J Med 1996;334:1557-60.  Back to cited text no. 15
16. Donadio JV Jr, Bergstralh EJ, Offord KP, Spencer DC, Holley KE. A controlled trial of fish oil in IgA nephropathy. Mayo Nephrology Collaborative Group. N Engl J Med 1994;331:1194-9.  Back to cited text no. 16
17. Iso H, Kobayashi M, Ishihara J, Sasaki S, Okada K, Kita Y, et al. Intake of fish and n3 fatty acids and risk of coronary heart disease among Japanese: The Japan Public Health Center-Based (JPHC) Study Cohort I. Circulation 2006;113:195-202.  Back to cited text no. 17
18. Khajehdehi P. Lipid-lowering effect of polyunsaturated fatty acids in hemodialysis patients. J Ren Nutr 2000;10:191-5.  Back to cited text no. 18
19. Schmitz PG, McCloud LK, Reikes ST, Leonard CL, Gellens ME. Prophylaxis of hemodialysis graft thrombosis with fish oil: Double-blind, randomized, prospective trial. J Am Soc Nephrol 2002;13:184-90.  Back to cited text no. 19
20. Sinzinger H, Leithner C. Eicosanoids of platelets and vascular wall in chronic renal insufficiency. Am J Nephrol 1987;7:212-20.  Back to cited text no. 20
21. Kooshki A, Taleban FA, Tabibi H, Hedayati M. Effects of marine omega-3 fatty acids on serum systemic and vascular inflammation markers and oxidative stress in hemodialysis patients. Ann Nutr Metab 2011;58:197-202.  Back to cited text no. 21
22. Jones WL, Kaiser SP. Pilot study (An emulsified fish oil supplement significantly improved C-reactive protein, hemoglobin, albumin and urine output in chronic hemodialysis volunteers). J Assoc Nurses AIDS 2002;5:45-50.  Back to cited text no. 22
23. Filiopoulos V, Hadjiyannakos D, Takouli L, Metaxaki P, Sideris V, Vlassopoulos D. Inflammation and oxidative stress in end-stage renal disease patients treated with hemodialysis or peritoneal dialysis. Int J Artif Organs 2009;32:872-82.  Back to cited text no. 23