The association between marine n-3 polyunsaturated fatty acid levels and survival after renal transplantation

• Published in: Clinical journal of the American Society of Nephrology Vol. 10; no. 7; pp. 1246 - 1256
• Main Authors: Eide, Ivar A, Jenssen, Trond, Hartmann, Anders, Diep, Lien M, Dahle, Dag O, Reisæter, Anna V, Bjerve, Kristian S, Christensen, Jeppe H, Schmidt, Erik B, Svensson, My
• Format: Journal Article
• Language: English
• Published: United States American Society of Nephrology 01-07-2015
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Animals; Cause of Death; Chromatography, Gas; Cohort Studies; Fatty Acids, Omega-3 - administration & dosage; Fatty Acids, Omega-3 - blood; Female; Fishes; Humans; Kaplan-Meier Estimate; Kidney Transplantation - adverse effects; Kidney Transplantation - mortality; Linear Models; Male; Middle Aged; Multivariate Analysis; Norway; Original; Proportional Hazards Models; Protective Factors; Registries; Risk Factors; Seafood; Time Factors; Treatment Outcome; Young Adult; Norway; mortality; ω3 fatty acids; survival; transplantation
• ISSN: 1555-9041; 1555-905X
• DOI: 10.2215/CJN.11931214

Several studies have reported beneficial cardiovascular effects of marine n-3 polyunsaturated fatty acids. To date, no large studies have investigated the potential benefits of marine n-3 polyunsaturated fatty acids in recipients of renal transplants.
In this observational cohort study of 1990 Norwegian recipients of renal transplants transplanted between 1999 and 2011, associations between marine n-3 polyunsaturated fatty acid levels and mortality were investigated by stratified analysis and multivariable Cox proportional hazard regression analysis adjusting for traditional and transplant-specific mortality risk factors. Marine n-3 polyunsaturated fatty acid levels in plasma phospholipids were measured by gas chromatography in a stable phase 10 weeks after transplantation.
There were 406 deaths (20.4%) during a median follow-up period of 6.8 years. Mortality rates were lower in patients with high marine n-3 polyunsaturated fatty acid levels (≥7.95 weight percentage) compared with low levels (<7.95 weight percentage) for all age categories (pooled mortality rate ratio estimate, 0.69; 95% confidence interval, 0.57 to 0.85). When divided into quartiles according to marine n-3 polyunsaturated fatty acid levels, patients in the upper quartile compared with the lower quartile had a 56% lower risk of death (adjusted hazard ratio, 0.44; 95% confidence interval, 0.26 to 0.75) using multivariable Cox proportional hazard regression analysis. There was a lower hazard ratio for death from cardiovascular disease with high levels of marine n-3 polyunsaturated fatty acid and a lower hazard ratio for death from infectious disease with high levels of the marine n-3 polyunsaturated fatty acid eicosapentaenoic acid, whereas there was no association between total or individual marine n-3 polyunsaturated fatty acid levels and cancer mortality.
Higher plasma phospholipid marine n-3 polyunsaturated fatty acid levels were independently associated with better patient survival.