Homan van der Heide J J, Bilo H J, Donker A J, Wilmink J M, Sluiter W J, Tegzess A M
Department of Internal Medicine, University Hospital Groningen, Amsterdam, The Netherlands.
Transplantation. 1992 Aug;54(2):257-63.
In a randomized prospective coconut oil (daily 6g[63% C8:0 and 36% C10:0] [EPA-] [n = 48])-controlled trial, we investigated the effect of a one-month dietary supplementation with daily 6 g fish oil (30% C20:5 omega-3 and 20% C22:6 omega-3 as their methyl esthers [EPA+] [n = 40]) on the incidence and course of early postoperative rejection in 88 first cadaveric, cyclosporine-treated renal transplant recipients. At one month there were no differences in renal function and incidence of rejection episodes. When analyzed separately for rejection (re+) or nonrejection (re-), the rejecting and fish oil-treated patients showed a significant better recovery of renal function after a histologically confirmed rejection episode, creatinine clearance being 43 ml/min/1.73m2 in the EPA+re+group versus 27 ml/min/1.73 m2 in the EPA-re+group (P less than 0.05), and serum creatinine being 183 and 283 mumol/l (P less than 0.05), respectively. The prerejection renal function and the decline of renal function during the rejection episode did not differ significantly between the EPA+re+ and the EPA-re+ groups. The nonrejecting fish oil-treated patients showed no better renal function than the nonrejecting coconut oil-treated patients. However, cyclosporine trough levels were significantly higher in the fish oil-treated group (EPA+re- 251 versus EPA-re- 200 ng/ml [P less than 0.05]). From these results we conclude that dietary supplements with fish oil favorably influence renal function in the recovery phase following a rejection episode in cyclosporine-treated renal transplant recipients. We further conclude that one month after grafting there is no difference in the incidence of rejection episodes between the fish- and coconut oil-treated patients. The same holds true for renal function in the absence of rejection, and for the decline in renal function during a rejection episode.
在一项随机前瞻性椰子油（每日6克[63% C8:0和36% C10:0] [不含EPA] [n = 48]）对照试验中，我们研究了每日补充6克鱼油（30% C20:5 ω-3和20% C22:6 ω-3作为它们的甲酯[含EPA] [n = 40]）进行为期一个月的饮食补充，对88例首次接受尸体肾移植且接受环孢素治疗的患者术后早期排斥反应的发生率及病程的影响。在1个月时，肾功能和排斥反应发作的发生率没有差异。当分别对发生排斥反应（re+）和未发生排斥反应（re-）的患者进行分析时，经组织学证实发生排斥反应后，接受鱼油治疗的发生排斥反应的患者肾功能恢复明显更好，EPA+re+组的肌酐清除率为43 ml/min/1.73m2，而EPA-re+组为27 ml/min/1.73 m2（P < 0.05），血清肌酐分别为183和283 μmol/l（P < 0.05）。EPA+re+组和EPA-re+组在排斥反应前的肾功能以及排斥反应发作期间肾功能的下降情况没有显著差异。未发生排斥反应且接受鱼油治疗的患者肾功能并不比未发生排斥反应且接受椰子油治疗的患者更好。然而，鱼油治疗组的环孢素谷浓度显著更高（EPA+re-为251 ng/ml，而EPA-re-为200 ng/ml [P < 0.05]）。从这些结果我们得出结论，饮食补充鱼油对接受环孢素治疗的肾移植受者在排斥反应发作后的恢复阶段的肾功能有有利影响。我们进一步得出结论，移植后1个月，接受鱼油和椰子油治疗的患者之间排斥反应发作的发生率没有差异。在未发生排斥反应时的肾功能以及排斥反应发作期间肾功能的下降情况也是如此。
