Peritoneal Dialysis Unit, Western Galilee Hospital, Naharyia, Israel.
Ren Fail. 2010;32(9):1031-5. doi: 10.3109/0886022X.2010.510231.
Cardiovascular complications are the main cause of mortality in patients with end-stage renal disease (ESRD). Peritoneal dialysis (PD) patients generally have a more atherogenic serum lipid profile. Although statins are the cornerstone of lipid-lowering therapy, there is an important role of fibrates in the treatment of hypertriglyceridemia. Fibrates increased the risk of rhabdomyolysis. ESRD patients are at risk for inadequate omega-3 intake as a result of renal dietary recommendations. In the general population omega-3 fatty acids play an important modulatory role in lipid regulation, immune and inflammatory responses, progression of arteriosclerosis, and cardiovascular disease.
To evaluate the effect of oral omega-3 administration on plasma lipid levels and inflammatory markers in PD patients.
Fifteen adult and stable PD patients who did not receive omega-3 or fibrates treatment before were included in the study. All subjects followed the usual dialysis diet and regimen and continued with the same cholesterol-lowering statins. The patients were treated with daily oral 2.4 g docosahexaenoic acid and 1 g eicosapentaenoic acid supplementation in three divided doses with meals for 8 weeks. Triglycerides, LDL-C, HDL-C, and inflammation markers were evaluated before the administration of omega-3 and at 8 weeks.
Triglyceride levels were decreased significantly (p = 0.001). Total, HDL and LDL cholesterol levels were not affected. ESR, CRP, IL-6, TNF-α, 4-hydroxynonenal, and malondialdehyde levels reduced insignificantly.
This short-term pilot study demonstrated the efficacy, safety, and well tolerability of omega-3 in the treatment of hypertriglyceridemia in PD patients.
心血管并发症是终末期肾病(ESRD)患者死亡的主要原因。腹膜透析(PD)患者的血清脂质谱通常更具动脉粥样硬化性。尽管他汀类药物是降脂治疗的基石,但贝特类药物在治疗高甘油三酯血症方面也有重要作用。贝特类药物增加了横纹肌溶解症的风险。由于肾脏的饮食建议,ESRD 患者可能存在ω-3 摄入不足的风险。在普通人群中,ω-3 脂肪酸在脂质调节、免疫和炎症反应、动脉粥样硬化进展以及心血管疾病中发挥着重要的调节作用。
评估口服ω-3 对 PD 患者血浆脂质水平和炎症标志物的影响。
本研究纳入了 15 名成年且稳定的 PD 患者,他们在入组前未接受过 ω-3 或贝特类药物治疗。所有患者均遵循常规透析饮食和方案,并继续使用相同的降脂他汀类药物。患者接受每日口服 2.4 克二十二碳六烯酸和 1 克二十碳五烯酸,分三次随餐服用,疗程为 8 周。在服用 ω-3 之前和 8 周时评估甘油三酯、LDL-C、HDL-C 和炎症标志物。
甘油三酯水平显著降低(p=0.001)。总胆固醇、HDL-C 和 LDL-C 水平不受影响。ESR、CRP、IL-6、TNF-α、4-羟壬烯醛和丙二醛水平降低不明显。
这项短期初步研究表明,ω-3 在治疗 PD 患者的高甘油三酯血症方面具有疗效、安全性和良好的耐受性。