Higher Serum Omega-3 Polyunsaturated Fatty Acid Content Is Associated with Improved Long-Term Cardiovascular and Renal Outcomes in Patients with Chronic Kidney Disease.

Background

Patients with chronic kidney disease (CKD) exhibit reduced serum levels of n-3 polyunsaturated fatty acids (PUFA). Alterations in fatty acid profiles may contribute to increased cardiovascular risk and potentially accelerate CKD progression. Aim: The aim of the study was to assess whether fatty acid profiles measured a decade earlier predicted CKD progression and cardiovascular events. Additionally, the impact of dietary patterns at baseline was evaluated.

Methods

The study comprised 77 patients with CKD whose serum fatty acid profiles had been assessed approximately a decade earlier. Follow-up data on CKD progression, cardiovascular events, and all-cause mortality were collected. Dietary habits were assessed using a food frequency questionnaire. The composite endpoint was defined as renal replacement therapy initiation or occurrence of stroke, myocardial infarction, or death.

Results

Higher n-3 PUFA content was significantly associated with a lower risk of the composite endpoint in Cox regression analysis (HR = 0.63; 95% CI: 0.40-0.99; p = 0.044). Significant differences in event-free survival were observed in patients with higher n-3/n-6 PUFA ratios (log-rank test, χ2 = 4.58, p = 0.032). Patients who experienced stroke or myocardial infarction had significantly higher levels of n-6 PUFA (32.85% vs. 29.94% Mann-Whitney U test, p = 0.037) and lower n-3/n-6 PUFA ratios (0.07 vs. 0.08, Mann-Whitney U test, p = 0.045). Eicosapentaenoic acid (EPA) content was significantly lower at baseline in patients who required renal replacement therapy during follow-up compared with those who did not experience this outcome (0.66% [0.48-0.82] vs. 0.88% [0.64-1.13], Mann-Whitney U test, p = 0.02).

Conclusions

Lower serum n-3 PUFA levels were observed in patients who reached the composite endpoint during follow-up. A higher n-3/n-6 PUFA ratio showed a protective effect in survival analysis, and higher EPA content was associated with a lower risk of renal replacement therapy initiation. A more favorable fatty acid profile may be linked to improved cardiovascular and renal outcomes. Further studies are needed to clarify the role of fatty acid profiles in long-term outcomes among patients with CKD, in whom cardiovascular disease remains the leading cause of death.