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一项针对透析前慢性肾病患者的ω-3脂肪酸补充剂的随机、双盲、安慰剂对照临床试验。

A Randomized, Double-Blind, Placebo-Controlled Clinical Trial of an Omega-3 Fatty Acid Supplement in Patients With Predialysis Chronic Kidney Disease.

作者信息

Bunout Daniel, Barrera Gladys, Hirsch Sandra, Lorca Eduardo

机构信息

Aging Department, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile.

Aging Department, Institute of Nutrition and Food Technology, University of Chile, Santiago, Chile.

出版信息

J Ren Nutr. 2021 Jan;31(1):64-72. doi: 10.1053/j.jrn.2020.04.004. Epub 2020 Jul 28.

DOI:10.1053/j.jrn.2020.04.004
PMID:32732154
Abstract

OBJECTIVE

Omega-3 fatty acids may reduce albuminuria and cardiovascular risk factors in patients with chronic kidney disease (CKD). We aimed to assess the effects of omega-3 fatty acid supplementation on albuminuria, blood pressure, pulse wave velocity, and inflammatory markers in patients with CKD.

METHODS

Patients with CKD and a urine albumin excretion of at least 30 mg/g creatinine were supplemented for 3 months with 3,666 mg/day of docosahexaenoic and eicosapentaenoic acids or a corn oil supplement. The study was double blind. At baseline, 6 weeks, and 12 weeks, fasting blood and morning spot urine samples were obtained. Blood pressure, carotid intima media thickness, and pulse wave velocity were measured. The main outcome measure was a reduction of ≥20% in urine albumin.

RESULTS

One hundred patients were randomized (50 received omega-3 fatty acids and 50 received corn oil). Four patients who received omega-3 fatty acids and 5 who received vegetable oil were lost to follow-up. In patients receiving omega-3 fatty acids, the omega-3 index increased from 3.08 (2.32-3.81) to 5.48 (3.045-7.04) percent. A 20% reduction in urine albumin excretion was observed in 13 participants of the control group and 19 participants of omega-3 group (Fisher's exact P = .274). However, the supplement had a significant and positive effect on pulse wave velocity and triglyceride level.

CONCLUSION

An omega-3 fatty acid supplement of 3,666 mg/day did not modify urine albumin excretion in patients with CKD but did improve pulse wave velocity and serum triglyceride levels.

摘要

目的

ω-3脂肪酸可能会降低慢性肾脏病(CKD)患者的蛋白尿及心血管危险因素。我们旨在评估补充ω-3脂肪酸对CKD患者蛋白尿、血压、脉搏波速度及炎症标志物的影响。

方法

尿白蛋白排泄量至少为30mg/g肌酐的CKD患者,每天补充3666mg二十二碳六烯酸和二十碳五烯酸或玉米油补充剂,为期3个月。该研究为双盲研究。在基线、6周和12周时,采集空腹血和晨尿样本。测量血压、颈动脉内膜中层厚度和脉搏波速度。主要结局指标为尿白蛋白减少≥20%。

结果

100例患者被随机分组(50例接受ω-3脂肪酸,50例接受玉米油)。4例接受ω-3脂肪酸的患者和5例接受植物油的患者失访。接受ω-3脂肪酸的患者中,ω-3指数从3.08(2.32 - 3.81)%增至5.48(3.045 - 7.04)%。对照组13名参与者和ω-3组19名参与者的尿白蛋白排泄量减少了20%(Fisher精确检验P = 0.274)。然而,该补充剂对脉搏波速度和甘油三酯水平有显著的正向影响。

结论

每天补充3666mgω-3脂肪酸并未改变CKD患者的尿白蛋白排泄,但改善了脉搏波速度和血清甘油三酯水平。

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