Renal effects of dietary supplementation with fish oil in cyclosporine-treated liver transplant recipients

✍ Scribed by Salvatore Badalamenti; Francesco Salerno; Elettra Lorenzano; Gianni Paone; Giovanna Como; Silvia Finazzi; Anna Cristina Sacchetta; Antoni Rimola; Giorgio Graziani; Dinangelo Galmarini; Claudio Ponticelli

• Publisher: John Wiley and Sons
• Year: 1995
• Tongue: English
• Weight: 808 KB
• Volume: 22
• Category: Article
• ISSN: 0270-9139
• DOI: 10.1002/hep.1840220613

✦ Synopsis

Nephrotoxicity is the main untoward effect of cyclosporine (CsA) treatment. Experimental and clinical data suggest that dietary supplementation with fish oil may lessen cyclosporine nephrotoxicity, possibly by lowering renal thromboxane (Tx) production. We have studied the renal effects of a daily supplementation for 2 months of 12 g fish oil (18% C205 n-3 eicosapentaenoic acid [EPA] and 12% C22:6 n-3 docosahexanoic acid [DHA]) in a placebo-controlled (12 g corn oil), prospective, randomized, double-blind study of stable CsAtreated liver transplant recipients. Thirteen patients ingested corn oil capsules and 13 fish oil. Compliance with dietary regimen was confirmed by fatty acid chromatography that showed increased plasma concentrations of EPA (from 0.4 rt 0.02% to 4.6 I+_ 0.5%, P < .0001) and DHA (from 1.8 2 0.2% to 3.9 I+_ 0.1%, P < .0001) in the fish oil group and increased plasma concentration of linoleic acid ((2182 n-6) in the corn oil group (from 25 2 2% to 28.4 -C 2%, P < .001). At the end of the 2 months of the study, in the fish oil group the effective renal plasma flow increased by 22% (P = .012), the glomerular filtration rate increased by 33% (P = .057), the renal blood flow increased by 17% (P = .024), and the calculated total renal vascular resistances decreased by 20% (P = .OM).

In contrast, none of these parameters changed in the corn oil group. The renal functional reserve determined Abbreviations: CsA, cyclosporine A, EPA, eicosapentaenoic acid; DHA, docosahexanoic acid; TxB,, thromboxane Bz; OLT, orthotopic liver transplantation; ERPF, effective renal plasma flow; GFR, glomerular filtration rate; PRA, plasma renin activity; PA, plasma aldosterone; MAP, mean arterial pressure; TRVR, total renal vascular resistance.

From the 'Division of Nephrology and Dialysis,